Prognostic role of the pulmonary artery-to-aorta ratio and the N-terminal of prohormone brain natriuretic peptide in patients hospitalized with bronchiectasis exacerbation.

Background: Information regarding the role of the N-terminal of prohormone brain natriuretic peptide (NT-proBNP) and the ratio of the diameter of the pulmonary artery to the diameter of the aorta (PA:A ratio) on computed tomography in predicting prognosis in patients with bronchiectasis exacerbation is limited.

Methods: Retrospectively, patients with bronchiectasis exacerbation were classified into survivors and non-survivors based on 1-year mortality. Clinical, laboratory, and radiological variables were compared between the two groups.

Results: Based on 1-year mortality, patients (n = 389) were classified as non-survivors (67 [17.2 %]) or survivors (322 [82.8 %]). Age, body mass index <18.5 kg/m², ≥3 exacerbations in the previous year, NT-proBNP >404 pg/mL, and PA:A ratio >1 were independent predictors of 1-year mortality in patients hospitalized with bronchiectasis exacerbation. In terms of the prognostic performance of various factors for predicting 1-year mortality using receiver operating characteristic curves, NT-proBNP had the highest area under the curve, followed by PA:A ratio. Furthermore, the prognostic performance of the Bronchiectasis Severity Index, FACED score, NT-proBNP, and PA:A ratio in predicting 1-year mortality was assessed in 198 patients with spirometry results. Among these variables, the Bronchiectasis Severity Index exhibited the highest area under the curve, followed by NT-proBNP and PA:A ratio.

Conclusions: PA:A ratio and NT-proBNP may be valuable biomarkers for predicting 1-year mortality in patients with bronchiectasis exacerbation.