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Both systemic inflammation and exacerbations have been associated with greater severity of bronchiectasis. Our objective was to analyze the prognostic value of the peripheral concentration of C-reactive protein (CRP) for the number and severity of exacerbations in patients with bronchiectasis.Patients from the Spanish Bronchiectasis Registry (RIBRON) with valid data on their CRP value (in a clinically stable phase) and valid data on exacerbations during the first year of follow-up were included. A logistic regression analysis was used to evaluate the prognostic value of the CRP concentration (divided into tertiles) with the presence of at least one severe exacerbation or at least two mild-moderate exacerbations during the first year of follow-up.802 patients (mean age: 68.1 [11.1 years], 65% female) were included. Of these, 33.8% and 13%, respectively, presented ≥2 mild-moderate exacerbations or at least one severe exacerbation during the first year of follow-up. The mean value of the CRP was 6.5 (17.6mg/L). Patients with a CRP value between 0.4 and 2.7mg/L (second tertile) and ≥2.7mg/L (third tertile) presented a 2.9 (95%CI: 1.4-5.9) and 4.2 (95%CI: 2.2-8.2) times greater probability, respectively, of experiencing a severe exacerbation than those with0.4mg/L (control group), regardless of bronchiectasis severity or a history of previous exacerbations. However, the CRP value did not present any prognostic value for the number of mild-moderate exacerbations.The CRP value was associated with a greater risk of future severe exacerbations but not with mild or moderate exacerbations in patients with steady-state bronchiectasis.

The SEPAR Spanish Bronchiectasis Registry (RIBRON) began as a platform for the collection of longitudinal data on patients with this disease. The objective of this study is to describe its operation and to analyze the characteristics of bronchiectasis patients according to sex.A total of 1912 adult patients diagnosed with bronchiectasis in 43 centers were included between February 2015 and 2019. All patients had complete data consisting of at least 79 basic required variables, controlled by an external audit.Mean age was 67.6 (15.2) years; 63.9% were women. The most common symptom was productive cough (78.3%) which was mucopurulent-purulent in 45.9% of cases. The most common etiology was post-infectious (40.4%), while 18.5% were idiopathic. Pseudomonas aeruginosa was the most frequently isolated microorganism (40.4%), of which 25.6% were associated with chronic infection. The annual number of mild-to-moderate/severe exacerbations was 1.62 (1.9)/0.59 (1.3). Half of the patients (50%) presented with airflow obstruction (17% severe). The most frequent radiological localization was lower lobes. The average FACED/E-FACED/BSI values were 2.06 (1.7)/2.67 (2.2)/7.8 (4.5), respectively. Overall, 66.7% of patients were taking inhaled corticosteroids, 19.2% macrolides, and 19.5% inhaled antibiotics. Women presented a less severe profile than men in clinical and functional terms, and a similar infectious, radiological and therapeutic profile.RIBRON represents an excellent map of the characteristics of bronchiectasis in our country. Two thirds of patients are women who presented lower disease severity as a specific characteristic.

Objetivo Realizamos el estudio con el proposito de conocer, a traves de un cuestionario especifico, el impacto de la enfermedad pulmonar obstructiva cronica (EPOC) sobre las actividades de la vida diaria en un grupo amplio de pacientes en Espana. Asimismo estudiamos su relacion con parametros clinicos, funcionales y socioeconomicos, y con escalas validadas de calidad de vida, para evaluar su utilidad en la practica habitual y determinar que variables pueden definir a los pacientes “fragiles” o que requieren una mayor atencion. Metodos Se ha realizado un estudio observacional, descriptivo, multicentrico y transversal, con la participacion de 227 neumologos de toda Espana, que incluyo a pacientes con el diagnostico de EPOC. A todos estos se les paso un cuestionario especifico con 7 preguntas que median el impacto de la enfermedad sobre aspectos de la vida diaria Las respuestas se valoraron de 0 a 2, segun el grado de afectacion, lo que supone un intervalo entre 0 y 14 unidades. Definimos al paciente como “fragil” si presentaba valores iguales o mayores de 9 en el cuestionario de impacto. Se evaluo la relacion entre la escala de impacto y variables clinicas, situacion socioeconomica, espirometria y calidad de vida medida con el cuestionario especifico St. George's Respiratory Questionnaire (SGRQ). Resultados Estudiamos a 1.057 pacientes (un 95,2% varones), con una edad media (± desviacion estandar) de 67 ± 9 anos y volumen espiratorio forzado en el primer segundo (FEV1), expresado en porcentaje, del 41,8 ± 13,3%. La puntuacion media del cuestionario de impacto fue de 6,3 ± 3,1. Las actividades con mayor afectacion fueron deporte y ocio, actividad fisica habitual y vida sexual (mucha afectacion en el 52,5, el 30,3 y el 20,2% de los pacientes, respectivamente). Encontramos relacion entre la puntuacion del cuestionario y parametros conocidos de gravedad (SGRQ, disnea, numero de agudizaciones y FEV1 expresado en litros). Los pacientes definidos como fragiles tenian mayor edad y menor nivel tanto cultural como economico. Conclusiones El cuestionario de impacto de la EPOC se correlaciona bien con los clasicos parametros clinicos y funcionales de valoracion de la gravedad de la enfermedad (disnea, FEV1 y exacerbaciones) y con el cuestionario de calidad de vida relacionada con la salud SGRQ. Asi pues, podria ser un instrumento util para identificar un perfil de paciente fragil, que presenta, ademas de una peor situacion clinica y funcional, una situacion socioeconomica mas desfavorecida.