In bronchiectasis, poor physical capacity correlates with poor quality of life

Jarkko Mäntylä; Witold Mazur; Tanja Törölä; Paula Bergman; Paula Kauppi

doi:10.1080/20018525.2022.2095104

In bronchiectasis, poor physical capacity correlates with poor quality of life

Eur Clin Respir J. 2022 Jun 30;9(1):2095104. doi: 10.1080/20018525.2022.2095104. eCollection 2022.

Authors

Jarkko Mäntylä¹, Witold Mazur¹, Tanja Törölä², Paula Bergman³, Paula Kauppi¹

Affiliations

¹ University of Helsinki and Helsinki University Hospital, Heart and Lung Center, Department of Respiratory Diseases, Espoo, Finland.
² University of Helsinki and Helsinki University Hospital, Inflammation Center, Department of Allergy, Espoo, Finland.
³ University of Helsinki, Biostatistics Consulting, Department of Public Health, University of Helsinki, Espoo, Finland.

Abstract

Purpose: Patients with bronchiectasis (BE) who suffer frequent exacerbations are likely to experience negative effects on quality of life (QoL) and require more healthcare utilization. We aimed to discover, in a cohort of Finnish BE patients, those risk factors that influence QoL.

Methods: Non-cystic fibrosis BE patients of a Helsinki University Hospital cohort were examined with high-resolution computed tomography (HRCT) of the chest. They completed a disease-specific quality of life-bronchiectasis (QoL-B) questionnaire in Finnish translation. We considered scores in the lowest quarter (25%) of that QoL-B scale to indicate poor QoL. The bronchiectasis severity index (BSI), FACED score, and modified Medical Research Council (mMRC) dyspnoea scale were used.

Results: Overall, of 95 adult BE patients, mean age was 69 (SD ± 13) and 79% were women. From the cohort, 82% presented with chronic sputum production and exacerbations, at a median rate of 1.7 (SD ± 1.6). The number of exacerbations (OR 1.7), frequent exacerbations (≥3 per year) (OR 4.9), high BSI score (OR 1.3), and extensive disease (≥3 lobes) (OR 3.7) were all predictive of poor QoL. Frequent exacerbations were associated with bronchial bacterial colonisation, low forced expiratory volume in 1 s (FEV1), and radiological disease severity. Based on the BSI, 34.1% of our cohort had severe disease, with 11.6% classified as severe according to their FACED score. The mMRC dyspnoea score (r = -0.57) and BSI (r = -0.60) correlated, in the QoL-B questionnaire, negatively with physical domain.

Conclusion: The strongest determinants of poor QoL in the cohort of Finnish BE patients were frequent exacerbations, radiological disease severity, and high BSI score. Neither comorbidities nor BE aetiology appeared to affect QoL. Reduced physical capacity correlated with dyspnoea and severe disease.

Study registration: University of Helsinki, Faculty of Medicine, 148/16.08.2017.

Keywords: Bronchiectasis; bronchiectasis severity index; exacerbation; extensive disease; quality of life.

Grants and funding

This study was supported by funding of the Foundation of the Finnish Anti-Tuberculosis Association, the Finnish Research Foundation of the Pulmonary Diseases, and the University of Helsinki and Helsinki University Hospital, Heart and Lung Center, Department of Respiratory Diseases, Helsinki, FinlandThe Finnish Research Foundation of the Pulmonary Diseases.