Present outlook in bronchiectasis: clinical and social study and review of factors influencing prognosis.

Abstract

One hundred and sixteen patients with proven bronchiectasis diagnosed at least five years previously were studied to determine the clinical outcome, change in pulmonary function, and degree of social disability. Twenty-two patients had died and the mean duration of follow-up in the survivors was 14 years. The patients who died were characterised by a poorer initial ventilatory capacity than the survivors and cor pulmonale was present in 37 % at the time of death. The survivors showed a tendency for improvement in symptoms whether treated surgically or medically. Thirty per cent were better than at diagnosis while only 11 % were worse. Measurements of FEV1 and FVC were made at diagnosis and at review, mild airways obstruction being the predominant abnormality. The change in pulmonary function was expressed as the decline in FEV1 in ml/yr. The decline in FEV1 was no greater than expected in 80 % of patients and in a further 15 % was of the order seen in cigarette smokers with mild airways obstruction. Poor ventilatory capacity was therefore not an important limitation in these patients. Of the survivors 77 % had a good work record with less than two weeks loss of work annually from chest illness. The spouses of all married patients were interviewed at home by a trained social worker. Fifty per cent reported no social problem but 46 % of spouses found the patient's cough distasteful and 29 % of couples had experienced difficulties with normal sexual life. Seven per cent of the patients were severely disabled. While the overall prognosis of our patients was good a minority still have severe physical and social problems as a result of bronchiectasis.

Mortality in bronchiectasis: a long-term study assessing the factors influencing survival

“…Bronchiectasis affected a total of 304 (56.8%) out of a possible 535 lobes examined on CT scan. Spirometry showed that airflow obstruction was the predominant finding in this group of bronchiectasis patients, with an average forced expiratory volume in 1 s (FEV1) of 1.85 L?min -1 (65.8% predicted) and forced vital capacity of 3.05 L (88.7% pred), which is in accordance with other studies [15][16][17].…”

An Investigation into Causative Factors in Patients with Bronchiectasis

“…The importance of lung damage occurring after pneumonia, pertussis, measles, or tuberculosis as a cause of bronchiectasis, though often cited (16,24,27,28), is hard to estimate because of inaccurate recall and reporting and the ability of most people to make a full recovery without lasting pulmonary symptoms after these infections (29). We have made the assumption for the purposes of definition that chronic upper respiratory tract symptoms (rhinosinusitis) reflect an underlying airway or immunologic disorder.…”

Predominant pathogen competition and core microbiota divergence in chronic airway infection

“…It is associated with chronic and frequently purulent expectoration, multiple exacerbations and progressive dyspnoea that can become disabling (Ellis et al, 1981;Cohen and Sahn, 1999;Barker, 2002), and represents a substantial and growing health-care burden. A recent US study demonstrated a marked increased prevalence in older populations varying from 4.2/100 000 adults aged 18-34 years to 271.8/100 000 aged X75 years (Weycker et al, 2005).…”