Quality of life and inflammation in exacerbations of bronchiectasis

Abstract

Patients with bronchiectasis often have impaired quality of life (QoL), which deteriorates with exacerbations. The aim of this study was to investigate changes in QoL and how these were influenced by changes in airway physiology and inflammation in patients with bronchiectasis before and after resolution of an exacerbation. Sputum induction and a QoL questionnaire were undertaken on the first day, day 14, and 4 weeks after completion of intravenous antibiotics (day 42). Eighteen patients (12 female) were recruited, median (IQ range) age of 54 (47-60) years. There was a trend towards an improvement in lung function from visit 1 to visit 2, but this was not statistically significant. C-reactive protein (CRP) [mean (SEM)] reduced between visit 1 and visit 2 [55.4 (21.5) vs 9.4 (3.1) mg/L, P = 0.03] but did not increase significantly on visit 3 [44.4 (32.9) mg/L, P = 0.27]. The median (interquartile range) sputum cell count (x10(6) cells/g of sputum) decreased from visit 1 to visit 2 [21.6 (11.8-37.6)-13.3 (6.7-22.9) x 10(6) cells/g, respectively, P = 0.008] and increased from visit 2 to visit 3 [26.3 (14.1-33.6) x 10(6) cells/g, P = 0.03]. All soluble markers of inflammation significantly reduced from visit 1 to visit 2 but increased on visit 3 with the exception of TNF-alpha. Regarding QoL, three of the four domains (dyspnoea, emotional, mastery) significantly improved from visit 1 to visit 2 but did not change between visit 2 and visit 3. The improvements in QoL scores could not be explained by the improvements in lung function or inflammatory markers.

The Burden of Disease in Pediatric Non-Cystic Fibrosis Bronchiectasis

“…14 The DASS-21 is a commonly used tool to measure the variations in emotional state in adults, though there is limited data on parents of children with chronic disease. Data from a cohort of children with chronic cough reported by Marchant et al 7 show that the median DASS-21 score was 10 and the median PC-QOL score was 3.38.…”

Antibiotics for bronchiectasis exacerbations in children: rationale and study protocol for a randomised placebo-controlled trial

“…Unfortunately, data on triggers, definitions and effective treatment of bronchiectasis exacerbations in both children and adults are scarce [56,61,62]. Although viral triggers of acute exacerbations are well described in asthma [46] and COPD [63,64], no such data exist for bronchiectasis.…”

Quality of Life and Bronchial Hyper-Responsiveness in Subjects With Bronchiectasis: Validation of the Seattle Obstructive Lung Disease Questionnaire in Bronchiectasis

“…Additionally, several studies concluded that exacerbations in subjects with bronchiectasis can adversely affect HRQOL, and treatment of exacerbations might lead to improvement in quality of life. [22][23][24] It is clear that this issue needs more study. People live with chronic diseases that can adversely affect their HRQOL.…”