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Quality of life and inflammation in exacerbations of bronchiectasis

Respiratory Research Centre, Belfast City Hospital, Belfast, Northern Ireland; Respiratory Medicine Research Cluster, Queen's University Belfast, Belfast, Northern Ireland courtneyjulia{at}hotmail.com

MG Kelly

Respiratory Research Centre, Belfast City Hospital, Belfast, Northern Ireland; Respiratory Medicine Research Cluster, Queen's University Belfast, Belfast, Northern Ireland

A Watt

Respiratory Medicine Research Cluster, Queen's University Belfast, Belfast, Northern Ireland

L Garske

Respiratory Research Centre, Belfast City Hospital, Belfast, Northern Ireland

J Bradley

Health and Rehabilitation Sciences Research Institute, University of Ulster, Belfast, Northern Ireland

M Ennis

Respiratory Medicine Research Cluster, Queen's University Belfast, Belfast, Northern Ireland

JS Elborn

Respiratory Research Centre, Belfast City Hospital, Belfast, Northern Ireland; Respiratory Medicine Research Cluster, Queen's University Belfast, Belfast, Northern Ireland

Patients with bronchiectasis often have impaired quality of life (QoL), which deteriorates with exacerbations. The aim of this study was to investigate changes in QoL and how these were influenced by changes in airway physiology and inflammation in patients with bronchiectasis before and after resolution of an exacerbation. Sputum induction and a QoL questionnaire were undertaken on the first day, day 14, and 4 weeks after completion of intravenous antibiotics (day 42). Eighteen patients (12 female) were recruited, median (IQ range) age of 54 (47–60) years. There was a trend towards an improvement in lung function from visit 1 to visit 2, but this was not statistically significant. C-reactive protein (CRP) [mean (SEM)] reduced between visit 1 and visit 2 [55.4 (21.5) vs 9.4 (3.1) mg/L, P = 0.03] but did not increase significantly on visit 3 [44.4 (32.9) mg/L, P = 0.27]. The median (interquartile range) sputum cell count (x10⁶ cells/g of sputum) decreased from visit 1 to visit 2 [21.6 (11.8–37.6)–13.3 (6.7–22.9) x 10⁶ cells/g, respectively, P = 0.008] and increased from visit 2 to visit 3 [26.3 (14.1–33.6) x 10⁶ cells/g, P = 0.03]. All soluble markers of inflammation significantly reduced from visit 1 to visit 2 but increased on visit 3 with the exception of TNF-. Regarding QoL, three of the four domains (dyspnoea, emotional, mastery) significantly improved from visit 1 to visit 2 but did not change between visit 2 and visit 3. The improvements in QoL scores could not be explained by the improvements in lung function or inflammatory markers.

Key Words: bronchiectasis • exacerbation • inflammation • quality of life

Chronic Respiratory Disease, Vol. 5, No. 3, 161-168 (2008)
DOI: 10.1177/1479972308091823


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