Poor Physical Capacity in Bronchiectasis Patients Is Correlated with Poor Quality of Life

Abstract BackgroundTo study the risk factors associated with quality of life (QoL) in a cohort of Finnish non-cystic fibrosis bronchiectasis (BE) patients. We aimed to evaluate which of the clinical characteristics were risk factors for poor quality of life, how patients with frequent exacerbations differed from those with only few exacerbations and if QoL symptom domains were correlated with dyspnoea or severity of BE.MethodsA cross-sectional study and part of the EMBARC study including questionnaire data and medical record data. Study participants were recruited between August 2016 and March 2018 from three different pulmonary clinics in Helsinki University Central Hospital (HUH) catchment area, Finland. The study included 95 adult patients with (mean age was 69 (SD± 13) years).A Finnish translation of the disease-specific quality of life-bronchiectasis (QoL-B) questionnaire was applied, and scores in the lowest quarter (25%) of the scale were considered to indicate poor QoL. The bronchiectasis severity index (BSI) and FACED (including FEV1, age, pulmonary bacterial colonization, affected lobes and dyspnoea) score were used. The severity of dyspnoea was examined using the modified Medical Research Council (mMRC) dyspnoea scale.ResultsAlmost all (82%) presented with chronic sputum production and exacerbations, with a median rate of 1.7 (SD ±1.6). Exacerbations (OR 1.7, p < 0.01), frequent exacerbations (OR 4.9, p < 0.01), high BSI score (OR 1.3, p < 0.01) and extensive disease (OR 3.7, p = 0.05) were predictive of poor QoL. Frequent exacerbations were associated with bronchial bacterial colonisation, low forced expiratory volume in one second (FEV1) and radiological disease severity. Based on the BSI, 34.1% of our cohort had severe disease, whereas 11.6% were classified as severe according to the FACED score. The mMRC dyspnoea score (r = -0.57) and BSI (r = -0.60) were negatively correlated with physical domain in QoL-B questionnaire. ConclusionFrequent exacerbations, radiological disease severity and high BSI score were predictive of poor QoL. Reduced physical capacity was correlated with dyspnoea and severity of disease. Interventions to reduce bacterial colonisation and to maintain physical functioning should be used to minimize exacerbations and to improve quality of life in BE patients.Study registrationUniversity of Helsinki, faculty of medicine; 148/16.08.2017