Quality-of-life determinants in patients with clinically stable bronchiectasis.

Abstract

STUDY OBJECTIVE: To determine the most important variables influencing health-related quality of life (HRQL) in patients with clinically stable bronchiectasis (SB). DESIGN: Cross-sectional study. PATIENTS AND INTERVENTIONS: A total of 86 patients (mean age, 69.5 years; SD, 8.9 years; 64% male) with SB were included. Data were collected on general patient characteristics, symptoms, laboratory findings, the extent of bronchiectasis, functional variables, medication in acute or stable phases, and the number of exacerbations. All patients completed the St. George Respiratory Questionnaire (SGRQ). Univariate and multivariate analyses were performed to identify the variables significantly influencing HRQL in these patients. RESULTS: Different clinical parameters (sputum, dyspnea, cough, and wheezing), spirometric variables, and laboratory parameters (fibrinogen), as well as the extent of bronchiectasis, medication, and the number of exacerbations were significantly correlated to the total questionnaire score, although only dyspnea (r2 = 0.43, p < 0.0001), FEV1 (r2 = 0.33, p < 0.0001), and daily sputum production (r2 = 0.2, p < 0.004) were independently correlated to the total score, globally explaining 55% of the total score variability. Systemic steroid treatment of exacerbations (r2 = 0.17, p < 0.028) and the habitual presence of coughing (r2 = 0.22, p < 0.004) and wheezing (r2 = 0.16, p < 0.013) were in turn independently correlated to the activity and symptoms subscales, respectively. CONCLUSION: Dyspnea, FEV1, and sputum production are the strongest conditioning factors of HRQL in patients with clinically SB.