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Characterization of lung function impairment in adults with bronchiectasis.
- Source :
-
PloS one [PLoS One] 2014 Nov 18; Vol. 9 (11), pp. e113373. Date of Electronic Publication: 2014 Nov 18 (Print Publication: 2014). - Publication Year :
- 2014
-
Abstract
- Background: Characteristics of lung function impairment in bronchiectasis is not fully understood.<br />Objectives: To determine the factors associated with lung function impairment and to compare changes in spirometry during bronchiectasis exacerbation and convalescence (1 week following 14-day antibiotic therapy).<br />Methods: We recruited 142 patients with steady-state bronchiectasis, of whom 44 with acute exacerbations in the follow-up were included in subgroup analyses. Baseline measurements consisted of chest high-resolution computed tomography (HRCT), sputum volume, purulence and bacteriology, spirometry and diffusing capacity. Spirometry, but not diffusing capacity, was examined during acute exacerbations and convalescence.<br />Results: In the final multivariate models, having bronchiectasis symptoms for 10 years or greater (OR = 4.75, 95%CI: 1.46-15.43, P = 0.01), sputum culture positive for Pseudomonas aeruginosa (OR = 4.93, 95%CI: 1.52-15.94, P<0.01) and HRCT total score being 12 or greater (OR = 7.77, 95%CI: 3.21-18.79, P<0.01) were the major variables associated with FEV1 being 50%pred or less; and the only variable associated with reduced DLCO was 4 or more bronchiectatic lobes (OR = 5.91, 95%CI: 2.20-17.23, P<0.01). Overall differences in FVC and FEV1 during exacerbations and convalescence were significant (P<0.05), whereas changes in other spirometric parameters were less notable. This applied even when stratified by the magnitude of FEV1 and DLCO reduction at baseline.<br />Conclusion: Significant lung function impairment should raise alert of chest HRCT abnormality and sputum culture positive for Pseudomonas aeruginosa, in patients with predominantly mild to moderate steady-state bronchiectasis. Acute exacerbations elicited reductions in FVC and FEV1. Changes of other spirometric parameters were less significant during exacerbations.<br />Trial Registration: ClinicalTrials.gov NCT01761214.
- Subjects :
- Adult
Bacteria classification
Bacteria isolation & purification
Bacterial Load
Bronchiectasis physiopathology
Cross-Sectional Studies
Drug Therapy, Combination
Female
Forced Expiratory Volume
Humans
Lung physiopathology
Male
Middle Aged
Multivariate Analysis
Prospective Studies
Pseudomonas aeruginosa isolation & purification
Respiratory Function Tests
Spirometry
Tomography, X-Ray Computed
Treatment Outcome
Anti-Bacterial Agents therapeutic use
Bronchiectasis drug therapy
Lung drug effects
Sputum microbiology
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 9
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 25405614
- Full Text :
- https://doi.org/10.1371/journal.pone.0113373