Association between Bronchiectasis Exacerbations and FEV1 Changes at A Tertiary Care Center

Bronchiectasis Exacerbations and FEV1 Changes

Abstract

Bronchiectasis, a common respiratory disease, presents a healthcare challenge since its evaluations do not often include health-related quality of life assessments. Objectives: To determine whether there is a correlation between the number of exacerbations experienced with non-cystic fibrosis bronchiectasis at baseline and the number of exacerbations experienced throughout follow-up, and identify any time-related changes in FEV1. Methods: 115 bronchiectasis patients were included prospectively. Evaluation of the correlation between exacerbations during the 24-month baseline period and 0-to-24-month and 24-to-48-month follow-up periods was done. Outcomes were changes in FEV1 and percentage of predicted FEV1 after 24 months, with stratification based on frequency of initial exacerbations. SPSS version 24.0 was used to analyze data. Results: 78 (67.8%) were female. The mean age was 63.7 years. The mean duration of bronchiectasis was 6.5 years. Mean BMI was 23.7 kg/m². The most common comorbidities were asthma and COPD. Frequency of exacerbations was 68 (59.1%). A baseline exacerbation was substantially linked to subsequent exacerbation at 0-24 months (p=0.0067) and 24-48 months (p<0.0002). Baseline FEV1 was considerably lower in patients with more exacerbations, but the drop was not significant between exacerbations. With more initial exacerbations, patients had substantially poorer FEV1 % predicted at baseline (p<0.0002), 12 (p=0.0003), and 24 months (p<0.0002). Conclusions: Patients with flaring up of bronchiectasis were more likely to experience future exacerbations and have a lower FEV1 to begin with. However, the drop in FEV1 may be unrelated to the frequency of exacerbations at baseline.