Bronchiectasis natural history, complications and prognosis: Difference between revisions
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==Natural History== | ==Natural History== | ||
*There is often a delay between the onset of symptoms and diagnosis | *There is often a delay between the onset of symptoms and diagnosis | ||
*The classic symptoms are [[cough]] | *The classic symptoms are [[cough]], daily [[mucopurulent]] [[sputum]] production, and [[dyspnea]] | ||
*These symptoms are usually present for months to years | :*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 | :*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== | ==Complications== | ||
*Recurrent [[infection]] | *Recurrent [[infection]] | ||
*Increased [[sputum]] production | *Increased [[sputum]] production | ||
*[[Dyspnea]] | *[[Dyspnea]] | ||
*Massive [[hemoptysis]] | *Massive [[hemoptysis]] | ||
*[[ | *[[ Pulmonary hypertension]] | ||
:*Decreased air is traveling through the [[bronchus]] | :*Decreased air is traveling through the [[bronchus]] | ||
:*Less oxygen is being distributed everywhere | :*Less oxygen is being distributed everywhere | ||
:*Causes pulmonary constriction which increases the pulmonary pressure | :*Causes pulmonary constriction which increases the pulmonary pressure | ||
*[[Cor pulmonale]] | *[[Cor pulmonale]] | ||
*[[Respiratory failure]] | *[[Respiratory failure]] | ||
==Prognosis== | ==Prognosis== | ||
| Line 32: | Line 31: | ||
*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> | *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> | ||
*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> | *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> | ||
*Infected with ''Pseudomonas aeruginosa'', severe exacerbations, and systemic [[inflammation]] are associated with disease advancement | *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)<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> | *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== | ==References== | ||
Revision as of 12:49, 1 July 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 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
Prognosis
- Bronchiectasis has been shown to contribute to early mortality[1]
- Early mortality is associated with males[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]
- 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)[3]
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.
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