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Multimorbidity in bronchiectasis: a systematic scoping review

Lookup NU author(s): Professor Anthony De SoyzaORCiD, Professor Miles WithamORCiD

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Abstract

© The authors 2023. Introduction Multimorbidity, the coexistence of two or more chronic conditions, has been extensively studied in certain disease states. Bronchiectasis aetiology is complex and multimorbidity is insufficiently understood. We performed a scoping review, summarising the existing literature and identifying deficits. Method A literature search of the electronic databases PubMed, CINAHL and EMBASE was conducted following PRISMA guidelines. Observational, interventional, qualitative, randomised control trials and systematic reviews were included. The main objective was to identify prevalence, prognosis, symptoms, quality of life and management in bronchiectasis multimorbidity. Key findings were analysed descriptively. Results 40 studies (200 567 patients) met the inclusion criteria, the majority (68%) being cohort studies. Study size ranged from 25 to 57 576 patients, with mean age 30–69 years. 70% of studies investigated the prognosis of comorbidities and 68% prevalence; 70% analysed multiple comorbidities in bronchiectasis. The most frequent comorbid diseases evaluated were COPD (58%), cardiovascular disease (53%) and asthma (40%). COPD and hypertension were the most prevalent conditions (pooled mean 35% and 34% respectively). Multimorbidity was associated with increased mortality, exacerbations and hospitalisation rates. It had a negative impact on lung function. Mortality increased in the following comorbidities: COPD, gastro-oesophageal reflux disease and rheumatoid arthritis. Conclusion Bronchiectasis multimorbidity is common. Research focuses on a few key aspects and favoured comorbidities (e.g. COPD). There is a deficit of research into symptoms, quality of life, interactions and management. High-resolution computed tomography diagnosis is not consistent, and there is no agreed multimorbidity screening questionnaire. Bronchiectasis multimorbidity is of importance; it is associated with morbidity and mortality.


Publication metadata

Author(s): Marsland I, Sobala R, de Soyza A, Witham M

Publication type: Review

Publication status: Published

Journal: ERJ Open Research

Year: 2023

Volume: 9

Issue: 1

Online publication date: 16/01/2023

Acceptance date: 19/10/2022

ISSN (electronic): 2312-0541

Publisher: European Respiratory Society

URL: https://doi.org/10.1183/23120541.00296-2022

DOI: 10.1183/23120541.00296-2022


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