O'Donnell et al defined an exacerbation of bronchiectasis by the presence of several clinical findings. These can help to identify a patient who may benefit from more aggressive management. The authors are from Georgetown University Medical Center, Oregon Health Sciences University, Winthrop University Hospital and Genentech.
Clinical parameters:
(1) sputum production
(2) dyspnea
(3) cough
(4) body temperature (fever, defined as > 38°C)
(5) wheezing
(6) systemic symptoms (fatigue, malaise, lethargy, exhaustion after exertion)
(7) pulmonary function
(8) changes in chest sounds
(9) changes on chest imaging studies
|
Parameter |
Finding |
Points |
|
sputum production |
decreased or unchanged |
0 |
|
|
changed (increased, purulent, hemoptysis) |
1 |
|
dyspnea |
decreased or unchanged |
0 |
|
|
increased |
1 |
|
cough |
decreased or unchanged |
0 |
|
|
increased |
1 |
|
body temperature |
decreased or unchanged |
0 |
|
|
increased, > 38°C |
1 |
|
wheezing |
decreased or unchanged |
0 |
|
|
increased |
1 |
|
system symptoms |
decreased or unchanged |
0 |
|
|
increased |
1 |
|
pulmonary function |
improved or unchanged |
0 |
|
|
reduced |
1 |
|
chest sounds |
normal or unchanged |
0 |
|
|
consistent with new pulmonary process |
1 |
|
chest imaging studies |
normal or unchanged |
0 |
|
|
consistent with new pulmonary process |
1 |
number of findings =
= (number of points for all 9 parameters))
Interpretation:
• minimum number of findings: 0
• maximum number of findings: 9
• An acute exacerbation was defined as >= 4 findings.
Purpose: To identify an exacerbation in a patient with bronchiectasis using the criteria of O'Donnell et al.
Specialty: Pulmonology
Objective: criteria for diagnosis, selection
ICD-10: J47,
