Bronchiectasis natural history, complications and prognosis

Bronchiectasis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Bronchiectasis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Chest X Ray
CT
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Bronchiectasis natural history, complications and prognosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Bronchiectasis natural history, complications and prognosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Bronchiectasis natural history, complications and prognosis
CDC on Bronchiectasis natural history, complications and prognosis
Bronchiectasis natural history, complications and prognosis in the news
Blogs on Bronchiectasis natural history, complications and prognosis
Directions to Hospitals Treating Bronchiectasis
Risk calculators and risk factors for Bronchiectasis natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2], Saarah T. Alkhairy, M.D.

Overview

Bronchiectasis is normally diagnosed after months or years of symptoms. Patients have respiratory complications, infection, and hemoptysis. Death can be caused by cardiac and respiratory failure. 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
• The classic symptoms are cough, daily mucopurulent sputum production, and dyspnea
  • These symptoms are usually present for months to years
  • The symptoms are manifestations of the lung being repeatedly damaged due to any number of causes

• Over the years the patient can develop recurrent infections, massive hemoptysis, and pulmonary hypertension

• In about 8-10 years, there is a high mortality rate due to cor pulmonale or respiratory failure

Complications

• Recurrent infection
• Increased sputum production
• Dyspnea
• Massive hemoptysis
• 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
• Respiratory failure

Prognosis

• Bronchiectasis has been shown to contribute to early mortality
• Early mortality is associated with
  • Males
  • Advanced age
  • Poor functional status
  • More severe disease based on radiographic findings
  • Evidence of hypoxemia or hypercapnia

• Infected with Pseudomonas aeruginosa, severe exacerbations, and systemic inflammation are associated with disease advancement
• Up to 10% of adults die within 5-8 years of diagnosis (majority being respiratory related)

References

​​​ Template:WH Template:WS