Abstract
One hundred and sixteen patients with proven bronchiectasis diagnosed at least five years previously were studied to determine the clinical outcome, change in pulmonary function, and degree of social disability. Twenty-two patients had died and the mean duration of follow-up in the survivors was 14 years. The patients who died were characterised by a poorer initial ventilatory capacity than the survivors and cor pulmonale was present in 37% at the time of death. The survivors showed a tendency for improvement in symptoms whether treated surgically or medically. Thirty per cent were better than at diagnosis while only 11% were worse. Measurements of FEV1 and FVC were made at diagnosis and at review, mild airways obstruction being the predominant abnormality. The change in pulmonary function was expressed as the decline in FEV1 in ml/yr. The decline in FEV1 was no greater than expected in 80% of patients and in a further 15% was of the order seen in cigarette smokers with mild airways obstruction. Poor ventilatory capacity was therefore not an important limitation in these patients. Of the survivors 77% had a good work record with less than two weeks loss of work annually from chest illness. The spouses of all married patients were interviewed at home by a trained social worker. Fifty per cent reported no social problem but 46% of spouses found the patient's cough distasteful and 29% of couples had experienced difficulties with normal sexual life. Seven per cent of the patients were severely disabled. While the overall prognosis of our patients was good a minority still have severe physical and social problems as a result of bronchiectasis.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- CLARK N. S. Bronchiectasis in childhood. Br Med J. 1963 Jan 12;1(5323):80–88. doi: 10.1136/bmj.1.5323.80. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cherniack N. S., Carton R. W. Factors associated with respiratory insufficiency in bronchiectasis. Am J Med. 1966 Oct;41(4):562–571. doi: 10.1016/0002-9343(66)90218-x. [DOI] [PubMed] [Google Scholar]
- Field C. E. Bronchiectasis. Third report on a follow-up study of medical and surgical cases from childhood. Arch Dis Child. 1969 Oct;44(237):551–561. doi: 10.1136/adc.44.237.551. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fletcher C., Peto R. The natural history of chronic airflow obstruction. Br Med J. 1977 Jun 25;1(6077):1645–1648. doi: 10.1136/bmj.1.6077.1645. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Glauser E. M., Cook C. D., Harris G. B. Bronchiectasis: a review of 187 cases in children with follow-up pulmonary function studies in 58. Acta Paediatr Scand. 1966;(Suppl):1+–1+. doi: 10.1111/j.1651-2227.1966.tb14958.x. [DOI] [PubMed] [Google Scholar]
- Landau L. I., Phelan P. D., Williams H. E. Ventilatory mechanics in patients with bronchiectasis starting in childhood. Thorax. 1974 May;29(3):304–312. doi: 10.1136/thx.29.3.304. [DOI] [PMC free article] [PubMed] [Google Scholar]
- MCKIM A. Bronchiectasis as seen in an ambulant clinic service; a follow-up study of forty-nine cases over a minimum period of nine years. Am Rev Tuberc. 1952 Oct;66(4):457–476. doi: 10.1164/art.1952.66.4.457. [DOI] [PubMed] [Google Scholar]
- Pande J. N., Jain B. P., Gupta R. G., Guleria J. S. Pulmonary ventilation and gas exchange in bronchiectasis. Thorax. 1971 Nov;26(6):727–733. doi: 10.1136/thx.26.6.727. [DOI] [PMC free article] [PubMed] [Google Scholar]
- STRANG C. The fate of children with bronchiectasis. Ann Intern Med. 1956 Apr;44(4):630–656. doi: 10.7326/0003-4819-44-4-630. [DOI] [PubMed] [Google Scholar]
- Sanderson J. M., Kennedy M. C., Johnson M. F., Manley D. C. Bronchiectasis: results of surgical and conservative management. A review of 393 cases. Thorax. 1974 Jul;29(4):407–416. doi: 10.1136/thx.29.4.407. [DOI] [PMC free article] [PubMed] [Google Scholar]
- WYNN-WILLIAMS N. Observations on the treatment of bronchiectasis and its relation to prognosis. Tubercle. 1957 Apr;38(2):133–145. doi: 10.1016/s0041-3879(57)80010-5. [DOI] [PubMed] [Google Scholar]