Introduction Non-cystic fibrosis bronchiectasis is a chronic lung condition characterised by persistent cough, excessive sputum and recurrent chest infections. Symptoms also include dyspnoea, haemoptysis, depression and fatigue. The latter can have a major impact on patients' physical and psychosocial well-being. We investigated disease- and patient-related factors associated with quality of life, fatigue and depression in bronchiectasis.
Method Patients were recruited from the London Bronchiectasis Cohort. A clinical diagnosis of bronchiectasis was confirmed by review of previous CT imaging. A full medical history including exacerbations and aetiology, spirometry, and the SGRQ (for quality of life), CESD (depression), and FACIT (fatigue) questionnaires were completed at a baseline appointment. Statistics were analysed using SPSS.
Results 31 patients (25 female) were studied with a mean (SD) age of 58.8 (SD 12.0) years. The commonest aetiologies were post-infectious (15/31) and idiopathic (11/31). The median (IQR) self-reported exacerbation frequency was 3.0 (1.9–5.6)/year.
Frequent exacerbations were associated with poorer quality of life: there was a significant association between exacerbation frequency and the SGRQ score (r=0.46, p=0.013). Frequent exacerbations were also associated with greater baseline breathlessness (r=0.40, p=0.038), but not with lung function, depression or fatigue. Patients with greater disease severity (lower FEV1) also had more breathlessness (MRC: r=−0.38, p=0.046), and poorer quality of life (SGRQ: r=−0.50, p=0.005) but not greater depression or fatigue. The depression scale was not related to any of the disease or patient-related factors. The only patient or disease-related variable associated with fatigue was breathlessness (MRC: r=−0.57, p=0.002).
Conclusion The determinants of quality of life, depression and fatigue in non-CF bronchiectasis are different. Depression in this population appears to be independent of markers of disease severity such as FEV1, exacerbation frequency and MRC dyspnoea score.
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