P248 Associations of depression, fatigue and quality of life in adult non-CF bronchiectasis

Abstract

Introduction: Non-cystic fibrosis bronchiectasis is a chronic lungcondition characterised by persistent cough, excessive sputum andrecurrent chest infections. Symptoms also include dyspnoea,haemoptysis, depression and fatigue. The latter can have a majorimpact on patients' physical and psychosocial well-being. Weinvestigated disease- and patient-related factors associated withquality of life, fatigue and depression in bronchiectasis.Method Patients were recruited from the London BronchiectasisCohort. A clinical diagnosis of bronchiectasis was confirmed byreview of previous CT imaging. A full medical history includingexacerbations and aetiology, spirometry, and the SGRQ (for qualityof life), CESD (depression), and FACIT (fatigue) questionnaires werecompleted at a baseline appointment. Statistics were analysed usingSPSS. Results: 31 patients (25 female) were studied with a mean (SD) ageof 58.8 (SD 12.0) years. The commonest aetiologies were postinfectious(15/31) and idiopathic (11/31). The median (IQR) selfreportedexacerbation frequency was 3.0 (1.9-5.6)/year.Frequent exacerbations were associated with poorer quality oflife: there was a significant association between exacerbationfrequency and the SGRQ score (r=0.46, p=0.013). Frequent exacerbationswere also associated with greater baseline breathlessness(r=0.40, p=0.038), but not with lung function, depression orfatigue. Patients with greater disease severity (lower FEV1) also hadmore breathlessness (MRC: r=-0.38, p=0.046), and poorer qualityof life (SGRQ: r=-0.50, p=0.005) but not greater depression orfatigue. The depression scale was not related to any of the disease orpatient-related factors. The only patient or disease-related variableassociated with fatigue was breathlessness (MRC: r=-0.57,p=0.002).Conclusion The determinants of quality of life, depression andfatigue in non-CF bronchiectasis are different. Depression inthis population appears to be independent of markers of diseaseseverity such as FEV1, exacerbation frequency and MRC dyspnoeascore.