Fatigue in bronchiectasis.
BACKGROUND
Fatigue is a complex, disabling symptom in non-CF bronchiectasis (nCF-Br). Fatigue can be formally measured using the validated fatigue impact scale (FIS). The relationship between fatigue and clinically important factors such as airflow obstruction, breathlessness or Pseudomonas aeruginosa infection in nCF-Br is unclear.


OBJECTIVE
To measure the correlation between FIS scores and markers of disease severity in nCF-Br.


METHODS
A prospective cohort study.


METHODS
Patients attending a specialist service were studied. Lung function (FEV(1)% predicted), Medical Research Council dyspnoea score (MRCD), sputum culture results and FIS were recorded. Patients were categorized according to sputum culture into three subgroups: Pseudomonas 'colonization', 'isolation' and neither.


RESULTS
One hundred and seventeen consecutive patients were included. Average FEV(1)% predicted was 64% (SD ±28%). Twelve (10%) patients had Pseudomonas aeruginosa isolation; 47 (40%) patients had P. aeruginosa colonization. Fatigue levels were similar in patients with and without colonization (median 38 versus 32, P = 0.155). Significant fatigue (FIS > 40) was similar in all three Pseudomonas subgroups (P = 0.31, chi-square). Fatigue correlated with MRCD score (r = 0.57, P < 0.001) and FEV(1)% predicted (r = -0.30, P = 0.001). FEV(1)% predicted was lower in patients who had ever isolated or been colonized with P. aeruginosa (P ≤ 0.001).


CONCLUSIONS
There are significant correlations between FIS score and MRCD score and FEV(1)% predicted in bronchiectasis. Pseudomonas aeruginosa infection appears to be associated with poorer lung function, and higher MRCD scores, yet there is no significant association between P. aeruginosa status and fatigue.
Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DN, UK.
K L M
KL
Hester
J G
JG
Macfarlane
H
H
Tedd
H
H
Jary
P
P
McAlinden
L
L
Rostron
T
T
Small
J L
JL
Newton
A
A
De Soyza
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D001987:Bronchiectasis / Q000150:complications*; D015331:Cohort Studies; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000150:complications*; D011550:Pseudomonas aeruginosa; D012119:Respiration; D012129:Respiratory Function Tests; D013183:Sputum / Q000382:microbiology; D055815:Young Adult
D015415:Biomarkers