Bronchiectasis: A retrospective study of clinical and aetiological investigation in a general respiratory department

• Published in: Revista portuguesa de pneumologia (English ed.) 2015-01, Vol.21 (1), p.5-10
• Main Authors: Amorim, A, Bento, J, Vaz, A.P, Gomes, I, de Gracia, J, Hespanhol, V, Marques, A
• Format: Article
• Language: English
• Subjects: Adult; Aetiology; Ambulatory Care Facilities; Bronchiectasis; Bronchiectasis - diagnosis; Bronchiectasis - etiology; Clinical investigation; Female; Humans; Internal Medicine; Male; Middle Aged; Pulmonary/Respiratory; Respiratory service; Retrospective Studies
• ISSN: 2173-5115; 2173-5115
• DOI: 10.1016/j.rppnen.2014.06.009

AbstractBackgroundBronchiectasis can result from many diseases, which makes the aetiological investigation a complex process demanding special resources and experience. The aetiological diagnosis has been proven to be useful for the therapeutic approach.ObjectiveEvaluate how accurately and extensive the clinical and aetiological research was for adult bronchiectasis patients in pulmonology outpatient service which were not following a pre-existing protocol.MethodsWe retrospectively reviewed the records of 202 adult patients with bronchiectasis, including the examinations performed to explain the aetiology.ResultsThe mean age of the patients was 54 ± 15 years, there was a predominance of female (63.9%) and non-smoker (70%) patients. Functional evaluation showed a mild airway obstruction. The sputum microbiological examination was available for 168 patients (43.1% had 3 or more sputum examinations during one year). Immunoglobulins and α1-antitrypsin were measured in around 50% of the patients. The sweat test and the CF genotyping test were performed in 18% and 17% of the patients, respectively.The most commonly identified cause was post-infectious (30.3%), mostly tuberculosis (27.2%). No definitive aetiological diagnosis was established in 57.4% of the patients. We achieved a lower aetiological diagnosis if we compare our series with studies in which a diagnostic algorithm was applied prospectively.ConclusionsThe general characteristics of our patients were similar with other series. Detailed investigation of bronchiectasis is not a standard practice in our outpatient service. These results suggest that the use of a predefined protocol, based on current guidelines, could improve the assessment of these patients and facilitate the achievement of a definitive aetiology.