Clinical Characteristics and Prognostic Factors in Patients with Bronchiectasis Depending on Bronchodilator Response in Korean Bronchiectasis Cohort = Clinical Characteristics and Prognostic Factors in Patients with Bronchiectasis Depending on Bronchodilator Response in Korean Bronchiectasis Cohort

다국어 초록 (Multilingual Abstract)

Background
Bronchodilator response (BDR) is sometimes observed in patients with bronchiectasis but reports on the relations between BDR and clinical characteristics and prognosis of bronchiectasis are few. The aims of our study are to compare clinical characteristics and lung function and prognosis between group with BDR and without BDR in bronchiectasis.
Methods
Data were collected from the Korean Multicenter Bronchiectasis Audit and Research Collaboration (KMBARC) registry, a protocol for a multicenter observational cohort study on non-cystic fibrosis bronchiectasis in Korea. Among this total 1003 patients registry, we reviewed the medical records of 355 patients who underwent baseline spirometry and 1-year follow up spirometry. Significant BDR was defined as FEV1 or FVC improvement from pre-bronchodilator value by at least 200 mL and 12% or significant pulmonary function improvement which increase at least 12% and 200 mL in FEV1 or FVC at the point of 1-year follow-up spirometry.
Results
Among 355 patients, total sixty-nine patients (19.4%) had BDR on PFT. Among 69 patients with BDR, 24 patients (34%) had asthma history by doctor clinically and 45 patients (66%) did not. Patients with BDR used ICS plus LABA more frequently than patients without BDR (30.4% vs 18.1%, p=0.03). Patients with BDR showed worse pulmonary function compared with no BDR patients on baseline spirometry (FEV1%, 54.3% vs 62.4%) and also in 1-year follow up spirometry. Patients with BDR showed higher risk of emergency room visit (30.4% vs 17.8% p=0.03) and hospital admission (27.8% vs 15.3%, p=0.006) compared with no BDR patients. FACED score (FEV1% predicted, age, chronic colonization by Pseudomonas aeruginosa, radiological extent of the disease, and dyspnea) were high in patients with BDR (2.1 vs 2.6, p value 0.009) .
Conclusion
Significant BDR in bronchiectasis patients is associated with worse pulmonary function, more frequent ER visit and hospital admission and low FACED score.