Introduction: Data on factors related to mortality in patients with bronchiectasis exacerbation are insufficient. Computed tomography (CT) can measure the pectoralis muscle area (PMA) and is a useful tool to diagnose sarcopenia. This study aimed to evaluate whether PMA can predict mortality in patients with bronchiectasis exacerbation. Methods: Patients hospitalized due to bronchiectasis exacerbation at a single center were retrospectively divided into survivors and non-survivors based on 1-year mortality. Thereafter, a comparison of the clinical and radiologic characteristics was conducted between the two groups. Results: A total of 66 (14%) patients died at 1 year. In the multivariate analysis, age, BMI <18.4 kg/m2, sex-specific PMA quartile, ≥3 exacerbations in the previous year, serum albumin <3.5 g/dL, cystic bronchiectasis, tuberculosis-destroyed lung, and diabetes mellitus were independent predictors for the 1-year mortality in patients hospitalized with bronchiectasis exacerbation. A lower PMA was associated with a lower overall survival rate in the survival analysis according to sex-specific quartiles of PMA. PMA had the highest area under the curve during assessment of prognostic performance in predicting the 1-year mortality. The lowest sex-specific PMA quartile group exhibited higher disease severity than the highest quartile group. Conclusions: CT-derived PMA was an independent predictor of 1-year mortality in patients hospitalized with bronchiectasis exacerbation. Patients with lower PMA exhibited higher disease severity. These findings suggest that PMA might be a useful marker for providing additional information regarding prognosis of patients with bronchiectasis exacerbation.

1.
Hill
AT
,
Sullivan
AL
,
Chalmers
JD
,
De Soyza
A
,
Elborn
SJ
,
Floto
AR
, et al
.
British thoracic society guideline for bronchiectasis in adults
.
Thorax
.
2019
;
74
(
Suppl 1
):
1
69
.
2.
Polverino
E
,
Goeminne
PC
,
McDonnell
MJ
,
Aliberti
S
,
Marshall
SE
,
Loebinger
MR
, et al
.
European Respiratory Society guidelines for the management of adult bronchiectasis
.
Eur Respir J
.
2017
;
50
(
3
):
1700629
.
3.
Chalmers
JD
,
Goeminne
P
,
Aliberti
S
,
McDonnell
MJ
,
Lonni
S
,
Davidson
J
, et al
.
The bronchiectasis severity index. An international derivation and validation study
.
Am J Respir Crit Care Med
.
2014
;
189
(
5
):
576
85
.
4.
Chalmers
JD
,
Aliberti
S
,
Filonenko
A
,
Shteinberg
M
,
Goeminne
PC
,
Hill
AT
, et al
.
Characterization of the “frequent exacerbator phenotype” in bronchiectasis
.
Am J Respir Crit Care Med
.
2018
;
197
(
11
):
1410
20
.
5.
Martínez-García
MA
,
Soler-Cataluña
JJ
,
Perpiñá-Tordera
M
,
Román-Sánchez
P
,
Soriano
J
.
Factors associated with lung function decline in adult patients with stable non-cystic fibrosis bronchiectasis
.
Chest
.
2007
;
132
(
5
):
1565
72
.
6.
Finklea
JD
,
Khan
G
,
Thomas
S
,
Song
J
,
Myers
D
,
Arroliga
AC
.
Predictors of mortality in hospitalized patients with acute exacerbation of bronchiectasis
.
Respir Med
.
2010
;
104
(
6
):
816
21
.
7.
Huang
HY
,
Chung
FT
,
Lin
CY
,
Lo
CY
,
Huang
YT
,
Huang
YC
, et al
.
Influence of comorbidities and airway clearance on mortality and outcomes of patients with severe bronchiectasis exacerbations in taiwan
.
Front Med
.
2021
;
8
:
812775
.
8.
Scioscia
G
,
Alcaraz-Serrano
V
,
Mendez
R
,
Gabarrús
A
,
Fernández-Barat
L
,
Menéndez
R
, et al
.
Factors associated with one-year mortality in hospitalised patients with exacerbated bronchiectasis
.
Arch Bronconeumol
.
2022
;
58
(
11
):
773
5
.
9.
Cruz-Jentoft
AJ
,
Bahat
G
,
Bauer
J
,
Boirie
Y
,
Bruyère
O
,
Cederholm
T
, et al
.
Sarcopenia: revised European consensus on definition and diagnosis
.
Age Ageing
.
2019
;
48
(
4
):
601
31
.
10.
Pahor
M
,
Manini
T
,
Cesari
M
.
Sarcopenia: clinical evaluation, biological markers and other evaluation tools
.
J Nutr Health Aging
.
2009
;
13
:
724
8
.
11.
Kim
YS
,
Kim
EY
,
Kang
SM
,
Ahn
HK
,
Kim
HS
.
Single cross-sectional area of pectoralis muscle by computed tomography - correlation with bioelectrical impedance based skeletal muscle mass in healthy subjects
.
Clin Physiol Funct Imaging
.
2017
;
37
(
5
):
507
11
.
12.
Diaz
AA
,
Martinez
CH
,
Harmouche
R
,
Young
TP
,
McDonald
ML
,
Ross
JC
, et al
.
Pectoralis muscle area and mortality in smokers without airflow obstruction
.
Respir Res
.
2018
;
19
(
1
):
62
.
13.
Teigen
LM
,
John
R
,
Kuchnia
AJ
,
Nagel
EM
,
Earthman
CP
,
Kealhofer
J
, et al
.
Preoperative pectoralis muscle quantity and attenuation by computed tomography are novel and powerful predictors of mortality after left ventricular assist device implantation
.
Circ Heart Fail
.
2017
;
10
(
9
):
e004069
.
14.
Yokosuka
R
,
Imai
R
,
Ro
S
,
Murakami
M
,
Okafuji
K
,
Kitamura
A
, et al
.
Pectoralis muscle mass on chest CT at admission predicts prognosis in patients with pneumonia
.
Can Respir J
.
2021
;
2021
:
3396950
.
15.
Ufuk
F
,
Demirci
M
,
Sagtas
E
,
Akbudak
IH
,
Ugurlu
E
,
Sari
T
.
The prognostic value of pneumonia severity score and pectoralis muscle Area on chest CT in adult COVID-19 patients
.
Eur J Radiol
.
2020
;
131
:
109271
.
16.
Attaway
AH
,
Welch
N
,
Yadav
R
,
Bellar
A
,
Hatipoglu
U
,
Meli
Y
, et al
.
Quantitative computed tomography assessment of pectoralis and erector spinae muscle area and disease severity in chronic obstructive pulmonary disease referred for lung volume reduction
.
COPD
.
2021
;
18
(
2
):
191
200
.
17.
McDonald
ML
,
Diaz
AA
,
Ross
JC
,
San Jose Estepar
R
,
Zhou
L
,
Regan
EA
, et al
.
Quantitative computed tomography measures of pectoralis muscle area and disease severity in chronic obstructive pulmonary disease. A cross-sectional study
.
Ann Am Thorac Soc
.
2014
;
11
(
3
):
326
34
.
18.
Bak
SH
,
Kwon
SO
,
Han
SS
,
Kim
WJ
.
Computed tomography-derived area and density of pectoralis muscle associated disease severity and longitudinal changes in chronic obstructive pulmonary disease: a case control study
.
Respir Res
.
2019
;
20
(
1
):
226
.
19.
Wilson
AC
,
Bon
JM
,
Mason
S
,
Diaz
AA
,
Lutz
SM
,
Estepar
RSJ
, et al
.
Increased chest CT derived bone and muscle measures capture markers of improved morbidity and mortality in COPD
.
Respir Res
.
2022
;
23
(
1
):
311
.
20.
McDonald
MLN
,
Diaz
AA
,
Rutten
E
,
Lutz
SM
,
Harmouche
R
,
San Jose Estepar
R
, et al
.
Chest computed tomography-derived low fat-free mass index and mortality in COPD
.
Eur Respir J
.
2017
;
50
(
6
):
1701134
.
21.
Hill
AT
,
Haworth
CS
,
Aliberti
S
,
Barker
A
,
Blasi
F
,
Boersma
W
, et al
.
Pulmonary exacerbation in adults with bronchiectasis: a consensus definition for clinical research
.
Eur Respir J
.
2017
;
49
(
6
):
1700051
.
22.
Diaz
AA
,
Zhou
L
,
Young
TP
,
McDonald
ML
,
Harmouche
R
,
Ross
JC
, et al
.
Chest CT measures of muscle and adipose tissue in COPD: gender-based differences in content and in relationships with blood biomarkers
.
Acad Radiol
.
2014
;
21
(
10
):
1255
61
.
23.
Han
JH
,
Wilber
ST
.
Altered mental status in older patients in the emergency department
.
Clin Geriatr Med
.
2013
;
29
(
1
):
101
36
.
24.
Martinez-Garcia
MA
,
de Gracia
J
,
Vendrell Relat
M
,
Giron
RM
,
Máiz Carro
L
,
de la Rosa Carrillo
D
, et al
.
Multidimensional approach to non-cystic fibrosis bronchiectasis: the FACED score
.
Eur Respir J
.
2014
;
43
(
5
):
1357
67
.
25.
Al-Harbi
A
,
Al-Ghamdi
M
,
Khan
M
,
Al-Rajhi
S
,
Al-Jahdali
H
.
Performance of multidimensional severity scoring systems in patients with post-tuberculosis bronchiectasis
.
Int J Chron Obstruct Pulmon Dis
.
2020
;
15
:
2157
65
.
26.
Mateus
SP
,
Ribeiro-Alves
M
,
Salles
REB
,
Costa
W
,
Costa
CH
,
Lopes
AJ
, et al
.
Mortality and comorbidities in patients with bronchiectasis over a 3-year follow-up
.
Medicine
.
2022
;
101
(
52
):
e32537
.
27.
Lee
SJ
,
Kim
HJ
,
Kim
JY
,
Ju
S
,
Lim
S
,
Yoo
JW
, et al
.
Serum albumin and disease severity of non-cystic fibrosis bronchiectasis
.
Respir Care
.
2017
;
62
(
8
):
1075
84
.
28.
Wang
X
,
Balaña-Corberó
A
,
Martínez-Llorens
J
,
Qin
L
,
Xia
Y
,
Zha
J
, et al
.
Respiratory and peripheral muscle weakness and body composition abnormalities in non-cystic fibrosis bronchiectasis patients: gender differences
.
Biomedicines
.
2022
;
10
(
2
):
334
.
29.
Ozalp
O
,
Inal-Ince
D
,
Calik
E
,
Vardar-Yagli
N
,
Saglam
M
,
Savci
S
, et al
.
Extrapulmonary features of bronchiectasis: muscle function, exercise capacity, fatigue, and health status
.
Multidiscip Respir Med
.
2012
;
7
(
1
):
3
.
30.
de Camargo
AA
,
Boldorini
JC
,
Holland
AE
,
de Castro
RAS
,
Lanza
FC
,
Athanazio
RA
, et al
.
Determinants of peripheral muscle strength and activity in daily life in people with bronchiectasis
.
Phys Ther
.
2018
;
98
(
3
):
153
61
.
31.
Ozalp
O
,
Inal-Ince
D
,
Cakmak
A
,
Calik-Kutukcu
E
,
Saglam
M
,
Savci
S
, et al
.
High-intensity inspiratory muscle training in bronchiectasis: a randomized controlled trial
.
Respirology
.
2019
;
24
(
3
):
246
53
.
32.
O’Neill
K
,
O’Donnell
AE
,
Bradley
JM
.
Airway clearance, mucoactive therapies and pulmonary rehabilitation in bronchiectasis
.
Respirology
.
2019
;
24
(
3
):
227
37
.
33.
O’Brien
ME
,
Zou
RH
,
Hyre
N
,
Leader
JK
,
Fuhrman
CR
,
Sciurba
FC
, et al
.
CT pectoralis muscle area is associated with DXA lean mass and correlates with emphysema progression in a tobacco-exposed cohort
.
Thorax
.
2023
;
78
(
4
):
394
401
.
34.
Xiaoyan
W
,
Yu
X
,
Xiaoyan
Y
,
Min
L
,
Yanwei
L
,
Huaping
D
.
Chest wall muscle mass depletion is related to certain pulmonary functions and diseases in patients with bronchiectasis
.
Chron Respir Dis
.
2022
;
19
:
14799731221105517
.
35.
Seo
H
,
Cha
SI
,
Park
J
,
Lim
JK
,
Park
JE
,
Choi
SH
, et al
.
Hemoptysis as the presenting manifestation of bronchiectasis-associated hospitalization in Korea
.
J Thorac Dis
.
2023
;
15
(
7
):
3636
45
.
36.
Olveira
G
,
Olveira
C
,
Dona
E
,
Palenque
FJ
,
Porras
N
,
Dorado
A
, et al
.
Oral supplement enriched in HMB combined with pulmonary rehabilitation improves body composition and health related quality of life in patients with bronchiectasis (Prospective, Randomised Study)
.
Clin Nutr
.
2016
;
35
(
5
):
1015
22
.
37.
Sun
C
,
Anraku
M
,
Kawahara
T
,
Karasaki
T
,
Kitano
K
,
Nagayama
K
, et al
.
Respiratory strength and pectoralis muscle mass as measures of sarcopenia: relation to outcomes in resected non-small cell lung cancer
.
J Thorac Cardiovasc Surg
.
2022
;
163
(
3
):
779
87.e2
.
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