title: Pulmonary function abnormalities in adult patients with acute exacerbation of bronchiectasis: A retrospective risk factor analysis.
abstract: Lung function impairments, especially airflow obstruction, are important features during acute exacerbation in patients with bronchiectasis. Recognition of the risk factors associated with airflow obstruction is important in the management of these exacerbations. The medical records of adult patients admitted to the Peking University People's Hospital, Beijing, China, from 2004 to 2011 with a diagnosis of bronchiectasis were reviewed retrospectively. Univariate and multivariate analyses were used to evaluate the risk factors associated with airflow obstruction. Airflow obstruction was found in 55.6% of 156 patients hospitalized with acute exacerbation of bronchiectasis, and the risk factors associated with airflow obstruction included young age (≤14 years old) at diagnosis (odds ratio (OR) = 3.454, 95% confidence interval (CI) 1.709-6.982, p = 0.001) as well as the presence of chronic obstructive pulmonary disease (COPD; OR = 14.677, 95% CI 5.696-37.819, p = 0.001), asthma (OR = 3.063, 95% CI 1.403-6.690, p = 0.005), and wheezing on auscultation (OR = 3.279, 95% CI 1.495-7.194, p = 0.003). The C-reactive protein (13.9 mg/dl vs. 6.89 mg/dl, p = 0.005), partial pressure of arterial oxygen (66.7 ± 8.57 mmHg vs. 89.56 ± 12.80 mmHg, p < 0.001), and partial pressure of arterial carbon dioxide (40.52 ± 2.77 mmHg vs. 42.87 ± 5.39 mmHg, p = 0.02) profiles were different between patients with or without airflow obstruction. In addition, patients colonized with potential pathogenic microorganisms had a decreased diffusing capacity (56.0% vs. 64.7%, p = 0.04). Abnormal pulmonary function was common in hospitalized patients with bronchiectasis exacerbations. Airflow obstruction was correlated with the patient's age at diagnosis, as well as the presence of combined COPD and asthma, and wheezing on auscultation, which also resulted in more severe systemic inflammation and hypoxemia.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Xi Cheng, Beijing, China helloyl1979@126.com.
authors.forename: Yanliang
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Respiratory and Critical Care Medicine, Guiyang People's Hospital of Guizhou Province, Guizhou, China.
authors.forename: Yuqian
authors.initials: Y
authors.lastname: Niu
authors.affiliation: Department of Respiratory and Critical Care Medicine, The 263 Hospital of the People's Liberation Army, Tongzhou, Beijing, China.
authors.forename: Guizhen
authors.initials: G
authors.lastname: Tian
authors.affiliation: Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Xi Cheng, Beijing, China.
authors.forename: Jingan
authors.initials: J
authors.lastname: Wei
authors.affiliation: Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Xi Cheng, Beijing, China.
authors.forename: Zhancheng
authors.initials: Z
authors.lastname: Gao
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000503:physiopathology*; D000403:Airway Resistance; D001249:Asthma / Q000150:complications / Q000503:physiopathology*; D001944:Breath Tests; D001987:Bronchiectasis / Q000150:complications / Q000503:physiopathology*; D002097:C-Reactive Protein / Q000378:metabolism; D002245:Carbon Dioxide; D018450:Disease Progression; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006935:Hypercapnia / Q000503:physiopathology; D000860:Hypoxia / Q000503:physiopathology; D007320:Inspiratory Capacity; D008297:Male; D008875:Middle Aged; D010100:Oxygen; D010313:Partial Pressure; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology*; D012115:Residual Volume; D012189:Retrospective Studies; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology; D014797:Vital Capacity
chemical_list: D002245:Carbon Dioxide; D002097:C-Reactive Protein; D010100:Oxygen
keywords: Bronchiectasis; airflow obstruction; exacerbation; microbiology; pulmonary function