Characterization of lung function impairment in adults with bronchiectasis

PLoS One. 2014 Nov 18;9(11):e113373. doi: 10.1371/journal.pone.0113373. eCollection 2014.


Background: Characteristics of lung function impairment in bronchiectasis is not fully understood.

Objectives: To determine the factors associated with lung function impairment and to compare changes in spirometry during bronchiectasis exacerbation and convalescence (1 week following 14-day antibiotic therapy).

Methods: We recruited 142 patients with steady-state bronchiectasis, of whom 44 with acute exacerbations in the follow-up were included in subgroup analyses. Baseline measurements consisted of chest high-resolution computed tomography (HRCT), sputum volume, purulence and bacteriology, spirometry and diffusing capacity. Spirometry, but not diffusing capacity, was examined during acute exacerbations and convalescence.

Results: In the final multivariate models, having bronchiectasis symptoms for 10 years or greater (OR = 4.75, 95%CI: 1.46-15.43, P = 0.01), sputum culture positive for Pseudomonas aeruginosa (OR = 4.93, 95%CI: 1.52-15.94, P<0.01) and HRCT total score being 12 or greater (OR = 7.77, 95%CI: 3.21-18.79, P<0.01) were the major variables associated with FEV1 being 50%pred or less; and the only variable associated with reduced DLCO was 4 or more bronchiectatic lobes (OR = 5.91, 95%CI: 2.20-17.23, P<0.01). Overall differences in FVC and FEV1 during exacerbations and convalescence were significant (P<0.05), whereas changes in other spirometric parameters were less notable. This applied even when stratified by the magnitude of FEV1 and DLCO reduction at baseline.

Conclusion: Significant lung function impairment should raise alert of chest HRCT abnormality and sputum culture positive for Pseudomonas aeruginosa, in patients with predominantly mild to moderate steady-state bronchiectasis. Acute exacerbations elicited reductions in FVC and FEV1. Changes of other spirometric parameters were less significant during exacerbations.

Trial registration: NCT01761214.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteria / classification
  • Bacteria / isolation & purification
  • Bacterial Load
  • Bronchiectasis / drug therapy*
  • Bronchiectasis / physiopathology
  • Cross-Sectional Studies
  • Drug Therapy, Combination
  • Female
  • Forced Expiratory Volume
  • Humans
  • Lung / drug effects*
  • Lung / physiopathology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prospective Studies
  • Pseudomonas aeruginosa / isolation & purification
  • Respiratory Function Tests
  • Spirometry
  • Sputum / microbiology*
  • Tomography, X-Ray Computed
  • Treatment Outcome


  • Anti-Bacterial Agents

Associated data