Opinion

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Prognosis For Patients Diagnosed With Bronchiectasis

Trajectory of patient outcomes for those diagnosed with bronchiectasis is explored by Dr Metersky.

This is a video synopsis/summary of an Insights involving Mark Metersky, MD, FCCP, on the prognosis of bronchiectasis.

The prognosis varies based on severity, especially if treated aggressively early on. With treatment, most patients can have a normal life expectancy, though slow symptom progression often occurs. At initial evaluation, patients are counseled that bronchiectasis will likely persist lifelong as an annoyance rather than severely limiting. Evidence supports improved quality of life with specialty center care, though high-quality generalist care can replicate good outcomes.

The bronchiectasis severity index stratifies prognosis based on multiple factors like age, comorbidities, lung function, and chronic bacterial airway infection. Most patients have nonsevere disease without dramatically shortened survival. Death directly related to bronchiectasis is unusual.

Worse outcomes are predicted by chronic Pseudomonas airway infection and frequent exacerbations of 3 or more per year despite aggressive therapy. These patients tend to remain frequent exacerbators.

There are no FDA-approved bronchiectasis treatments. One nonapproved therapy, chronic low-dose macrolide antibiotics, can reduce exacerbation frequency, but most frequent exacerbators stay that way.

Video synopsis is AI-generated and reviewed by AJMCÒ editorial staff.

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