Impact of Comorbidities and Severity on Outcomes in Bronchiectasis Excerbations

Impact of Comorbiditries and Disease Severity on Clinical Outcomes of Patients With Acute Exacerbations of Bronchiectesis

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.

Study Overview

• Status: Not yet recruiting
• Conditions: Bronchiectasis With Acute Exacerbation
• Intervention / Treatment: Other: Observational assessment of comorbidities and disease severity

Detailed 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.

• Study Type: Observational
• Enrollment (Estimated): 100

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population will include adult patients (≥18 years) diagnosed with bronchiectasis who are admitted to the hospital with acute exacerbations. Patients will be recruited from the Department of Chest Diseases at Sohag University Hospital (or your hospital name). All eligible patients during the study period will be included consecutively. Data regarding demographic characteristics, comorbidities, disease severity scores (BSI or FACED), and clinical outcomes will be collected and analyzed.

Description

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).

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

adult bronchiectasis patient with acute excerbations; 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.

Other: Observational assessment of comorbidities and disease severity; > This study involves no active intervention. Data will be collected from patients with acute exacerbations of bronchiectasis to assess the impact of comorbidities and disease severity on clinical outcomes such as hospital stay, ICU admission, and mortality.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Composite Clinical treatment failure during Bronchiectasis Exacerbation	composite clinical treatment failure,defined as the occurrence of any of the following events within 30 days of bronchiectasis exacerbation onset: 1.hospitalization related to the exacerbation 2.escalation or change of antibiotic therapy 3.Admission to the intensive care unit 4.Death from any cause	30 days after exacerbation onset

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
correlation between disease severity and clinical treatment failure	correlation between baseline bronchiectasis severity ,assessed using the bronchiectasis severity index(BSI), and clinical treatment failure during exacerbations.	1 year

Collaborators and Investigators

• Sponsor: Sohag University

Study record dates

Study Major Dates

• Study Start (Estimated): February 1, 2026
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2026

Study Registration Dates

• First Submitted: November 16, 2025
• First Submitted That Met QC Criteria: January 7, 2026
• First Posted (Estimated): January 16, 2026

Study Record Updates

• Last Update Posted (Estimated): January 16, 2026
• Last Update Submitted That Met QC Criteria: January 7, 2026
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Health Care Quality, Access, and Evaluation; Investigative Techniques; Epidemiologic Methods; Data Collection; Health Care Evaluation Mechanisms; Quality of Health Care; Public Health; Environment and Public Health; Health Surveys; Surveys and Questionnaires; Health Status Indicators; Patient Acuity
• Other Study ID Numbers: Soh-Med-25-9-16MS

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data (IPD) will not be shared. The collected data will be used only for the current study purposes and will remain confidential according to institutional regulations.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No