Bronchiectasis natural history, complications and prognosis: Difference between revisions

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{{Bronchiectasis}}
{{Bronchiectasis}}
{{CMG}} {{AE}} Saarah T. Alkhairy, M.D.


==Overview==
==Overview==
Bronchiectasis shows a higher mortality with males, advanced age, poor functional status, severe disease based on radiographic findings, and evidence of hypoxemia and hypercapnia.
Bronchiectasis shows a higher mortality with males, advanced age, poor functional status, severe disease based on radiographic findings, and evidence of hypoxemia and hypercapnia.


==Bronchiectasis Natural History, Complications, and Prognosis==
==Natural History==
*There is often a delay between the onset of symptoms and diagnosis.


==Complications==
*Recurrent infection
*Increased sputum production
*Dyspnea
*Massive hemoptysis
*Pneumonia
*Pulmonary hypertension
:*Decreased air is traveling through the bronchus
:*Less oxygen is being distributed everywhere
:*Causes pulmonary constriction which increases the pulmonary pressure
*Cor pulmonale (common cause of death)
*Respiratory failure (common cause of death)
==Prognosis==
*Bronchiectasis has been shown to contribute to early mortality.<ref name="pmid23728208">{{cite journal| author=McDonnell MJ, Ward C, Lordan JL, Rutherford RM| title=Non-cystic fibrosis bronchiectasis. | journal=QJM | year= 2013 | volume= 106 | issue= 8 | pages= 709-15 | pmid=23728208 | doi=10.1093/qjmed/hct109 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23728208  }} </ref>  
*Bronchiectasis has been shown to contribute to early mortality.<ref name="pmid23728208">{{cite journal| author=McDonnell MJ, Ward C, Lordan JL, Rutherford RM| title=Non-cystic fibrosis bronchiectasis. | journal=QJM | year= 2013 | volume= 106 | issue= 8 | pages= 709-15 | pmid=23728208 | doi=10.1093/qjmed/hct109 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23728208  }} </ref>  
**Factors associated with higher mortality were advanced age, poor functional status, more severe disease based on radiographic findings, and evidence of hypoxemia or hypercapnia.
*Factors associated with higher mortality are advanced age, poor functional status, more severe disease based on radiographic findings, and evidence of hypoxemia or hypercapnia.<ref>{{cite journal |author=Onen ZP, Eris Gulbay B, Sen E, Akkoca Yildiz O, Saryal S, Acican T, Karabiyikoglu G|title=Analysis of the factors related to mortality in patients with bronchiectasis. |language=English |journal= Respir Med. |volume=101 |issue=7 |pages=1390-97 |year=2007 |pmid=17374480 |doi=}}</ref>
 
*In US long-term cohort of 91 patients, 30% died during a 13-year follow-up period (median age 60 years).<ref name="pmid23728208">{{cite journal| author=McDonnell MJ, Ward C, Lordan JL, Rutherford RM| title=Non-cystic fibrosis bronchiectasis. | journal=QJM | year= 2013 | volume= 106 | issue= 8 | pages= 709-15 | pmid=23728208 | doi=10.1093/qjmed/hct109 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23728208  }} </ref>
*In US long-term cohort of 91 patients, 30% died during a 13-year follow-up period (median age 60 years).<ref name="pmid23728208">{{cite journal| author=McDonnell MJ, Ward C, Lordan JL, Rutherford RM| title=Non-cystic fibrosis bronchiectasis. | journal=QJM | year= 2013 | volume= 106 | issue= 8 | pages= 709-15 | pmid=23728208 | doi=10.1093/qjmed/hct109 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23728208  }} </ref>
*Early mortality is associated with males<ref name="pmid23728208">{{cite journal| author=McDonnell MJ, Ward C, Lordan JL, Rutherford RM| title=Non-cystic fibrosis bronchiectasis. | journal=QJM | year= 2013 | volume= 106 | issue= 8 | pages= 709-15 | pmid=23728208 | doi=10.1093/qjmed/hct109 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23728208  }} </ref>
*Infected with [[''Pseudomonas aeruginosa'']], severe exacerbations, and systemic inflammation are associated with disease advancement
*10% of adults die within 5-8 years of diagnosis (majority being respiratory related)


*Early mortality was associated with male sex.<ref name="pmid23728208">{{cite journal| author=McDonnell MJ, Ward C, Lordan JL, Rutherford RM| title=Non-cystic fibrosis bronchiectasis. | journal=QJM | year= 2013 | volume= 106 | issue= 8 | pages= 709-15 | pmid=23728208 | doi=10.1093/qjmed/hct109 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23728208  }} </ref>
*Bronchiectasis related to [[Pseudomonas aeruginosa]], severe exacerbations, systemic inflammation are associated with disease progression
*10% of adults with bronchiectasis die within 5-8 years of diagnosis, majority with the cause of death being respiratory related
*Good nutrition,ideal body weight, and regular vaccinations correlate with improved survival


==References==
==References==


{{Reflist|2}}
{{Reflist|2}}
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Revision as of 18:00, 26 June 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.

Overview

Bronchiectasis shows a higher mortality with males, advanced age, poor functional status, severe disease based on radiographic findings, and evidence of hypoxemia and hypercapnia.

Natural History

  • There is often a delay between the onset of symptoms and diagnosis.

Complications

  • Recurrent infection
  • Increased sputum production
  • Dyspnea
  • Massive hemoptysis
  • Pneumonia
  • Pulmonary hypertension
  • Decreased air is traveling through the bronchus
  • Less oxygen is being distributed everywhere
  • Causes pulmonary constriction which increases the pulmonary pressure
  • Cor pulmonale (common cause of death)
  • Respiratory failure (common cause of death)


Prognosis

  • Bronchiectasis has been shown to contribute to early mortality.[1]
  • Factors associated with higher mortality are advanced age, poor functional status, more severe disease based on radiographic findings, and evidence of hypoxemia or hypercapnia.[2]
  • In US long-term cohort of 91 patients, 30% died during a 13-year follow-up period (median age 60 years).[1]
  • Early mortality is associated with males[1]
  • Infected with ''Pseudomonas aeruginosa'', severe exacerbations, and systemic inflammation are associated with disease advancement
  • 10% of adults die within 5-8 years of diagnosis (majority being respiratory related)


References

  1. 1.0 1.1 1.2 McDonnell MJ, Ward C, Lordan JL, Rutherford RM (2013). "Non-cystic fibrosis bronchiectasis". QJM. 106 (8): 709–15. doi:10.1093/qjmed/hct109. PMID 23728208.
  2. Onen ZP, Eris Gulbay B, Sen E, Akkoca Yildiz O, Saryal S, Acican T, Karabiyikoglu G (2007). "Analysis of the factors related to mortality in patients with bronchiectasis". Respir Med. 101 (7): 1390–97. PMID 17374480.

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