Chronic bronchitis natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
Natural History
Depending on the severity of airflow obstruction which could be measured by FEV1, FVC and FEV1/FVC and at the time of diagnosis the prognosis may vary. It has a very wide range of severity from well controlled chronic bronchitis to severe obstructed airways with multiple exacerbations that needs hospitalization and even may develop to lung cancer[1].COPD usually gradually gets worse over time and can lead to death if left untreated.
Complications
Common complications of chronic bronchitis include:
- Recurrent pneumonia: Chronic inflammation and airways damage predispose chronic bronchitis patients to recurrent pneumonia either viral or bacterial infections. Additionally, chronic use of inhaled corticosteroids may cause recurrent infections[2].
- Depression: If it happens needs psychiatry consultation[3].
- Cor pulmonale: chronic hypoxia and subsequent vasoconstriction in pulmonary vasculature results in pulmonary hypertension and right sided heart failure which is named as cor pulmonale[4].
- Anemia: Anemia of chronic disease may develop in this patients and indicates a poor prognosis.
- Polycythemia: Secondary to chronic hypoxemia Hematocrit level may rise up to 60 ( normal range: Adult men: 46±4, adult women:40±4).
Prognosis
References
- ↑ Mannino DM, Buist AS, Petty TL, Enright PL, Redd SC (2003). "Lung function and mortality in the United States: data from the First National Health and Nutrition Examination Survey follow up study". Thorax. 58 (5): 388–93. PMC 1746680. PMID 12728157.
- ↑ Singh S, Amin AV, Loke YK (2009). "Long-term use of inhaled corticosteroids and the risk of pneumonia in chronic obstructive pulmonary disease: a meta-analysis". Arch. Intern. Med. 169 (3): 219–29. doi:10.1001/archinternmed.2008.550. PMID 19204211.
- ↑ Ohayon MM (2014). "Chronic Obstructive Pulmonary Disease and its association with sleep and mental disorders in the general population". J Psychiatr Res. 54: 79–84. doi:10.1016/j.jpsychires.2014.02.023. PMID 24656426.
- ↑ Klinger JR, Hill NS (1991). "Right ventricular dysfunction in chronic obstructive pulmonary disease. Evaluation and management". Chest. 99 (3): 715–23. PMID 1995228.