Exacerbations
Exacerbations are a strong predictor of morbidity and mortality (Elborn & Bell 2007) and are consequently one of the primary outcome measures in the management of people with bronchiectasis. Repeated exacerbations have been demonstrated to decrease lung function and quality of life (Wilson et al 1997). Physiotherapy airway clearance treatment and medical strategies aim to decrease exacerbations and may be based on:
frequency of exacerbations requiring antibiotics per year
time to exacerbation
Recognising an exacerbation
The presence of three or more of the following symptoms in one day (in particular related to sputum and cough) is a guideline for patients for the diagnosis of an exacerbation:
increased quantity of sputum
change in sputum colour
increased cough
increased lethargy
increased dyspnoea
increased sinus discharge
new or increased haemoptysis
fever or sweats