Abstract
Background: Patients with bronchiectasis are prone to frequent exacerbations which are a significant cause of morbidity and mortality. Our aim was to determine the clinical and investigational features of exacerbations in bronchiectasis.
Methods: A retrospective study of 40 respiratory exacerbations of bronchiectasis over a three years period. Clinical features, investigations and treatment related to the exacerbations were extracted and analyzed.
Results: The mean age was 45 years (20 to 86 years). Dyspnea (100%), increase in frequency of cough (82,5%), a change in its character (60%) and hemoptysis (25%) were the most common symptoms associated with an exacerbation. Half patients were admitted in acute respiratory failure. The average of C-reactive protein was 83 mg/l (0 to 344 mg/l). Partial pressure of arterial oxygen 77 mmhg. Bronchial infection and pneumonia were the most common etiologies of exacerbation. The average hospital stay was 12,7 (4 to 28 days). All patients received antibiotic therapy with a mean duration of 12 days. Spirometry showed restrictive syndrome in 40% of cases and the mean VEMS was 77% of predicted value (44 to 99 %). Thirty percent of patients were colonized by a pathogen: Pseudomonas (58%), Haemophilus influenzae (25%) and Klebsiella pneumoniae (2,5%). Chronic respiratory failure was observed in 32% of patients, 27.5 % home oxygen therapy and 5% of cases required a non-invasive ventilation.
Conclusion: Important clinical features of exacerbation in bronchiectasis were changes in cough frequency or character, and worsening chest signs; colonization with P. aeruginosa seems to have the highest impact on the clinical outcome.
- Copyright ©the authors 2016