Impact of Comorbidities and Severity on Outcomes in Bronchiectasis Excerbations

Sohag University

Status: Not yet enrolling

Conditions: Bronchiectasis With Acute Exacerbation

Treatments: Other: Observational assessment of comorbidities and disease severity

Study type: Observational

Funder types: Other

Identifiers

NCT07346625

Soh-Med-25-9-16MS

Details and patient eligibility

About

Acute exacerbations of bronchiectasis are associated with variable outcomes depending on patient factors. Comorbidities such as COPD, diabetes, and cardiovascular disease, as well as disease severity scores, significantly influence hospitalization rates, length of stay, need for intensive care, and mortality. Understanding these associations helps in risk stratification, guiding management, and improving prognosis in affected patients.

Full description

Bronchiectasis is a chronic respiratory condition characterized by permanent and abnormal dilatation of the bronchi, often associated with recurrent infections, impaired mucociliary clearance, and progressive lung damage. Acute exacerbations represent a major clinical problem, contributing to significant morbidity, reduced quality of life, and increased healthcare burden.

The clinical outcomes of patients experiencing acute exacerbations of bronchiectasis are not uniform, and multiple factors influence their prognosis. Among these, comorbidities and disease severity play crucial roles. Comorbidities such as chronic obstructive pulmonary disease (COPD), asthma, cardiovascular diseases, diabetes mellitus, and chronic renal impairment can increase susceptibility to exacerbations and worsen their clinical course. The presence of these comorbid conditions is often linked to prolonged hospital stays, higher rates of intensive care admission, frequent readmissions, and increased mortality.

Similarly, the severity of underlying bronchiectasis, often assessed through validated scoring systems (e.g., Bronchiectasis Severity Index [BSI], FACED score), is strongly correlated with outcomes during exacerbations. Patients with more severe disease tend to experience more frequent and severe exacerbations, impaired lung function, greater need for intravenous antibiotics, and higher risk of complications.

Therefore, assessing both comorbidity burden and disease severity is critical in predicting outcomes, guiding clinical decision-making, and tailoring individualized management strategies for patients presenting with acute exacerbations of bronchiectasis. A comprehensive understanding of these relationships will aid in early risk stratification, optimization of treatment, and potentially reduction of adverse outcomes in this vulnerable patient population.

Enrollment: 100 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adults (≥18 years) admitted with a diagnosis of "Bronchiectasis with acute exacerbation". The bronchiectasis exacerbation is diagnosed based on deterioration in three or more of the following main symptoms for 48h at least: cough, sputum volume or sputum consistency, purulent sputum, breathlessness or exercise tolerance, fatigue or malaise, hemoptysis, and the requirement of a change in the bronchiectasis treatment as determined by a clinician.

Exclusion criteria

• Patients younger than 18 years of age. Patients who refuse participation or whose medical records lack informed consent (if applicable).

Trial design

100 participants in 1 patient group

adult bronchiectasis patient with acute excerbations

Description:

Group 1: Mild-to-Moderate Disease Severity Patients diagnosed with bronchiectasis who present with acute exacerbations and have mild to moderate disease severity scores (based on BSI or FACED scoring). Data on comorbidities, clinical outcomes, and hospital stay will be recorded. Group 2: Severe Disease Severity Patients with acute exacerbations of bronchiectasis classified as severe according to BSI or FACED score. These patients are expected to have higher comorbidity burden and worse clinical outcomes. Alternative grouping (if by comorbidity burden): Group A: With Significant Comorbidities Patients with one or more major comorbidities such as COPD, diabetes, or cardiovascular disease. Group B: Without Significant Comorbidities Patients without major comorbid conditions, serving as a comparison group.

Treatment:

Other: Observational assessment of comorbidities and disease severity