Bronchiectasis natural history, complications and prognosis: Difference between revisions
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{{Bronchiectasis}} | {{Bronchiectasis}} | ||
{{CMG}}; {{AE}} {{HQ}}, 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 [[Lung|pulmonary]] constriction which increases the pulmonary pressure | |||
* | *[[Cor pulmonale]] | ||
*[[Respiratory failure]] | |||
*Early mortality | ==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> | |||
*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> | |||
**Advanced age<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> | |||
**Poor functional status<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> | |||
**More severe disease based on radiographic findings<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> | |||
**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> | |||
*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)<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> | |||
==References== | |||
{{Reflist|2}} | {{Reflist|2}} | ||
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{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Pulmonology]] | |||
[[Category:Medicine]] | |||
[[Category:Up-To-Date]] | |||
Latest revision as of 20:43, 29 July 2020
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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
Prognosis
- Bronchiectasis has been shown to contribute to early mortality[1]
- Early mortality is associated with
- 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)[6]
References
- ↑ 1.0 1.1 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.