Classification of Grossman for Bronchitis

Grossman reported a classification for bronchitis. The author is from the University of Toronto.

Findings	FEV1 as Percent of Predicted	Type
no underlying structural disease, usually self-limited	>= 50%	acute tracheobronchitis
increased sputum volume and purulence with <= 3 exacerbations per year and significant comorbidity	>= 50%	simple chronic bronchitis
increased sputum volume and purulence with one or more findings (see below)	variable	complicated chronic bronchitis
continuous sputum production throughout the year	variable	chronic bronchial infection

Findings associated with complicated chronic bronchitis - one or more of the following:

(1) >= 4 exacerbations per year

(2) FEV1 < 50% of predicted

(3) advanced age

(4) significant comorbidity (diabetes mellitus, chronic renal disease, congestive heart failure, chronic liver disease, cancer, etc)

With increasing severity there is:

(1) a greater need to treat with antibiotics

(2) a greater risk for encountering antibiotic resistance

(3) greater risk for morbidity and mortality

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