Thrombocytosis during Stable State Predicts Mortality in Bronchiectasis

Stefano Aliberti, Giovanni Sotgiu, Andrea Gramegna, Melissa J. McDonnell, Eva Polverino, Antoni Torres, Pieter C. Goeminne, Katerina Dimakou, Michal Shteinberg, Oriol Sibila, Valentina Conio, Thomas C. Fardon, Robert Rutherford, Simone Dore, Laura Saderi, Paola Faverio, Francesco Amati, Angelo G. Corsico, Francesco Blasi, James D. Chalmers

Research output: Contribution to journalArticlepeer-review

Abstract

Rationale: Although platelets are considered key inflammatory mediators in respiratory diseases, their role in bronchiectasis has not been fully explored.

Objectives: We hypothesized that thrombocytosis in stable state may be associated with bronchiectasis severity and worse clinical outcomes.

Methods: Bronchiectasis patients have been enrolled from 10 centers in Europe and Israel, with platelet count recorded during stable state. Primary outcome was five-year all-cause mortality. Secondary outcomes included exacerbations, hospitalizations, and mortality at one, two and three-year follow-up. Analyses were conducted using logistic regression after adjustment for confounding variables.

Results: Among the 1,771 patients (median age: 67 years; 63.4% females) included, 136 (7.7%) had thrombocytosis. Patients with thrombocytosis had a significant higher disease severity, worse quality of life, higher number of exacerbations and hospitalizations, and higher mortality rate at both three-year (23 [22.8%] vs. 83 [8.5%], respectively; p-value <0.01) and five-year (26 [35.1%] vs. 116 [15.9%], respectively; p-value <0.01) in comparison with those with normal platelet count. Thrombocytosis was significantly associated with hospitalizations due to severe exacerbations [OR (95% CI): 1.83 (1.20-2.79); p-value: 0.01] after one-year follow-up, as well as increased 3-year [OR (95% CI): 3.06 (1.74-5.39); p-value <0.01] and 5-year [OR (95% CI): 2.46 (1.39-4.37); p<0.01] mortality.

Conclusions: Platelets represent a cheap and easy to evaluate biomarker and the presence of thrombocytosis during stable state is associated with disease severity, hospitalizations due to exacerbations, poor quality of life and mortality in adults with bronchiectasis.

Original languageEnglish
JournalAnnals of the American Thoracic Society
Early online date28 Jan 2021
DOIs
Publication statusE-pub ahead of print - 28 Jan 2021

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