Bronchiectasis Patients Have Worse Quality of Life if Disease is COPD-related and More Severe, Study Says

Bronchiectasis Patients Have Worse Quality of Life if Disease is COPD-related and More Severe, Study Says

The quality of life of patients with bronchiectasis is heavily affected by the root cause and severity of their disease, with worse quality of life if the cause is related to chronic obstructive pulmonary disease, a study has found.

The findings of the study, “Aetiology and disease severity are among the determinants of quality of life in bronchiectasis,” were published in The Clinical Respiratory Journal. The study was led by researchers at Northwest Clinics Alkmaar in The Netherlands.

Bronchiectasis is a chronic lung disease that causes abnormal thickening of the airways, and excessive production of mucus. Because of its chronic nature and repeated acute flare-ups that sometimes require hospitalization, bronchiectasis has a strong negative impact on patients’ quality of life.

In most cases, the disease is triggered by another disorder, such as chronic obstructive pulmonary disease, or cystic fibrosis (CF).

“Previous studies evaluated the etiology [origin] of bronchiectasis in relation to different levels of disease severity … but failed to show significant differences, with the exception of a higher prevalence of chronic obstructive pulmonary disease (COPD) related bronchiectasis in patients with severe disease, and an excess of mortality in both COPD and rheumatoid arthritis related bronchiectasis,” the researchers wrote.

“In this line, there might be a relation between the etiology of bronchiectasis and the QoL [quality of life], suggesting a lower QoL in patients with an increasing disease severity and especially in patients with COPD-related bronchiectasis,” they added.

In the study, researchers in the Netherlands set out to examine if the underlying cause of bronchiectasis and disease severity have a direct impact on patients’ quality of life.

To that end, they carried out a retrospective study based on medical records of 200 patients with bronchiectasis (mean age of 69 years), who had participated in the European Bronchiectasis Network (EMBARC) database.

To assess the cause of bronchiectasis, the researchers reviewed the patients’ medical records and information from other diagnostic criteria. Disease severity was determined based on the bronchiectasis severity index (BSI), the FACED and E-FACED scores, and patients’ quality of life on the self-administered quality of life bronchiectasis (QoL-B) questionnaire.

Results showed the most common causes of bronchiectasis in this group of patients were post-infective (39.5%), asthma-related (14.5%), idiopathic (meaning undefined cause; 12.5%), immunodeficiency (12.5%), and COPD-related (12%).

Patients with COPD-related bronchiectasis had a significantly lower score on all subscales of the QoL-B questionnaire, compared with patients who had bronchiectasis associated with other medical conditions.

“According to the previous studies and the findings in our study it suggests that patients with COPD and bronchiectasis have a specific identity, which is earlier described as the possibility of a COPD bronchiectasis overlap syndrome,” the investigators noted.

In all patients analyzed, an increase in disease severity — assessed by BSI, FACED, and E-FACED scores — was associated with lower quality of life.

“Our analysis suggests that an increasing severity of the disease, especially by using the BSI, is correlated with a lower QoL,” the researchers wrote.

Overall, the findings suggest that quality of life in bronchiectasis patients “is related both to aetiology [cause], with worse QoL in COPD‐related bronchiectasis, and to disease severity,” the team concluded.

“These findings may alert clinicians to be more aware of QoL of these specific patient groups,” the researchers added.