The characteristics and prognosis of bronchiectasis patients with airflow limitation: a prospective longitudinal study

Abstract Background As bronchiectasis progresses, increasing degrees of airflow limitation can occur. Objectives This study aimed to investigate whether concomitant airflow limitation was associated with poor prognosis in patients with bronchiectasis and to identify the characteristics of patients w...

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Main Authors: Yuanting Cai, Linbin Xv, Zili Zhu, Shiyi He, Tianyu Sun, Chao Cao
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Pulmonary Medicine
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Online Access:https://doi.org/10.1186/s12890-024-03422-x
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author Yuanting Cai
Linbin Xv
Zili Zhu
Shiyi He
Tianyu Sun
Chao Cao
author_facet Yuanting Cai
Linbin Xv
Zili Zhu
Shiyi He
Tianyu Sun
Chao Cao
author_sort Yuanting Cai
collection DOAJ
description Abstract Background As bronchiectasis progresses, increasing degrees of airflow limitation can occur. Objectives This study aimed to investigate whether concomitant airflow limitation was associated with poor prognosis in patients with bronchiectasis and to identify the characteristics of patients with airflow limitation in bronchiectasis. Design A prospective longitudinal study was conducted to determine the characteristics and prognosis of bronchiectasis patients with airflow limitation. Methods We conducted a prospective longitudinal study. Patients who failed to complete the follow-up were withdrawn from the trial. High-resolution computed tomography (HRCT) was used for diagnosing bronchiectasis, whereas postbronchodilator forced expiratory volume in one second of the predicted value (post-FEV1%) was employed for grading airflow limitation. The main variables included questionnaires, anthropometric measurements, pulmonary function tests, laboratory tests, and CT findings. The primary outcome was frequent exacerbations. Differences among the groups were evaluated via two-tailed Student’s t test or ANOVA for continuous variables if the data were normally distributed. In the case of a nonnormal distribution, the Mann–Whitney U test and Kruskal–Wallis test were used. The chi-square test or Fisher’s exact test was used for categorical variables. Binary logistic regression analyses were used to identify factors and calculate the odds ratio (OR) for frequent exacerbations. Results A total of 189 subjects with bronchiectasis were enrolled in the study, including 97 patients with airflow limitation and 92 patients without airway obstruction. Patients with airflow limitation had greater numbers of exacerbations (1.46 ± 0.83 vs. 1.76 ± 1.10 times, P = 0.013) at 12 months after enrolment and greater numbers of hospitalizations (1.10 ± 0.30 vs. 1.36 ± 0.67 times, P = 0.0016) at 24 months after enrolment. In addition, acute exacerbations lasted longer (8.69 ± 3.78 vs. 13.11 ± 14.03 days, P = 0.0171), and the total number of hospitalizations was greater (1.34 ± 0.77 vs. 1.80 ± 1.67 times, P = 0.0421) for patients with a mean follow-up duration of 32 months (Table 3). Bronchiectasis patients with airflow limitation exhibit more severe manifestations of bronchiectasis both clinically and functionally. Furthermore, the cohort of bronchiectasis patients with airflow limitation had a significantly greater infection rate than did the BE group (P = 0.0244), with a notable disparity observed in the incidence of P. aeruginosa infection (P < 0.0001). Conclusion The results of our study suggest that patients with airflow limitation are more likely to experience acute exacerbations and hospitalizations than are those without airflow limitation. Patients with bronchiectasis concomitant with airflow limitation should be identified as early as possible, and individualized treatment methods should be formulated.
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spelling doaj-art-12da74166e7b4906b1846b9be65868e12025-08-20T02:20:38ZengBMCBMC Pulmonary Medicine1471-24662024-12-012411910.1186/s12890-024-03422-xThe characteristics and prognosis of bronchiectasis patients with airflow limitation: a prospective longitudinal studyYuanting Cai0Linbin Xv1Zili Zhu2Shiyi He3Tianyu Sun4Chao Cao5The First Affiliated Hospital of Ningbo UniversityThe First Affiliated Hospital of Ningbo UniversityThe First Affiliated Hospital of Ningbo UniversityThe First Affiliated Hospital of Ningbo UniversityNingbo UniversityThe First Affiliated Hospital of Ningbo UniversityAbstract Background As bronchiectasis progresses, increasing degrees of airflow limitation can occur. Objectives This study aimed to investigate whether concomitant airflow limitation was associated with poor prognosis in patients with bronchiectasis and to identify the characteristics of patients with airflow limitation in bronchiectasis. Design A prospective longitudinal study was conducted to determine the characteristics and prognosis of bronchiectasis patients with airflow limitation. Methods We conducted a prospective longitudinal study. Patients who failed to complete the follow-up were withdrawn from the trial. High-resolution computed tomography (HRCT) was used for diagnosing bronchiectasis, whereas postbronchodilator forced expiratory volume in one second of the predicted value (post-FEV1%) was employed for grading airflow limitation. The main variables included questionnaires, anthropometric measurements, pulmonary function tests, laboratory tests, and CT findings. The primary outcome was frequent exacerbations. Differences among the groups were evaluated via two-tailed Student’s t test or ANOVA for continuous variables if the data were normally distributed. In the case of a nonnormal distribution, the Mann–Whitney U test and Kruskal–Wallis test were used. The chi-square test or Fisher’s exact test was used for categorical variables. Binary logistic regression analyses were used to identify factors and calculate the odds ratio (OR) for frequent exacerbations. Results A total of 189 subjects with bronchiectasis were enrolled in the study, including 97 patients with airflow limitation and 92 patients without airway obstruction. Patients with airflow limitation had greater numbers of exacerbations (1.46 ± 0.83 vs. 1.76 ± 1.10 times, P = 0.013) at 12 months after enrolment and greater numbers of hospitalizations (1.10 ± 0.30 vs. 1.36 ± 0.67 times, P = 0.0016) at 24 months after enrolment. In addition, acute exacerbations lasted longer (8.69 ± 3.78 vs. 13.11 ± 14.03 days, P = 0.0171), and the total number of hospitalizations was greater (1.34 ± 0.77 vs. 1.80 ± 1.67 times, P = 0.0421) for patients with a mean follow-up duration of 32 months (Table 3). Bronchiectasis patients with airflow limitation exhibit more severe manifestations of bronchiectasis both clinically and functionally. Furthermore, the cohort of bronchiectasis patients with airflow limitation had a significantly greater infection rate than did the BE group (P = 0.0244), with a notable disparity observed in the incidence of P. aeruginosa infection (P < 0.0001). Conclusion The results of our study suggest that patients with airflow limitation are more likely to experience acute exacerbations and hospitalizations than are those without airflow limitation. Patients with bronchiectasis concomitant with airflow limitation should be identified as early as possible, and individualized treatment methods should be formulated.https://doi.org/10.1186/s12890-024-03422-xBronchiectasisAirflow limitationAirflow limitation in bronchiectasisAcute exacerbationHospitalizationFrequent exacerbations
spellingShingle Yuanting Cai
Linbin Xv
Zili Zhu
Shiyi He
Tianyu Sun
Chao Cao
The characteristics and prognosis of bronchiectasis patients with airflow limitation: a prospective longitudinal study
BMC Pulmonary Medicine
Bronchiectasis
Airflow limitation
Airflow limitation in bronchiectasis
Acute exacerbation
Hospitalization
Frequent exacerbations
title The characteristics and prognosis of bronchiectasis patients with airflow limitation: a prospective longitudinal study
title_full The characteristics and prognosis of bronchiectasis patients with airflow limitation: a prospective longitudinal study
title_fullStr The characteristics and prognosis of bronchiectasis patients with airflow limitation: a prospective longitudinal study
title_full_unstemmed The characteristics and prognosis of bronchiectasis patients with airflow limitation: a prospective longitudinal study
title_short The characteristics and prognosis of bronchiectasis patients with airflow limitation: a prospective longitudinal study
title_sort characteristics and prognosis of bronchiectasis patients with airflow limitation a prospective longitudinal study
topic Bronchiectasis
Airflow limitation
Airflow limitation in bronchiectasis
Acute exacerbation
Hospitalization
Frequent exacerbations
url https://doi.org/10.1186/s12890-024-03422-x
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