Objective: Limited data exists from developing countries describing the differences in clinical features of bronchiectasis according to lung function tests. Hence, this study aims to characterize the variation in clinical characteristics of bronchiectasis according to spirometry findings.

Methods: HRCT-diagnosed bronchiectasis patients were retrospectively investigated for spirometry findings and associated clinical features at a tertiary hospital in Pakistan. Patients were grouped as having obstructive, restrictive, mixed, and normal patterns on spirometry as per the ATS criteria.

Results: Of the 125 patients, 54.4% of the patients had obstructive pattern, 15.2% had restrictive pattern, 22.4% had mixed while 8% had normal spirometry. Of those with obstructive pattern 55.9% had severe disease (FEV1 < 50%). Patients with obstructive pattern had a higher percentage of bilateral lung disease (55%), frequent history of hospitalization (50.8%), and recurrent infections (59.3%). Patients with obstructive pattern also presented with increased occurrences of hemoptysis (57.14%), respiratory failure (66.7%), colonization with pseudomonas (60.6%) as well as > 5 exacerbations per year (55.6%). In addition, these patients were more dependent on non-invasive ventilation (66.7%) and long-term oxygen therapy (71.4%).

Conclusion: Majority patients in our cohort had obstructive pattern on spirometry with 55.9% having severe obstruction. Patients with obstructive disease had frequent exacerbations, hospitalizations, and need for long-term oxygen therapy or non-invasive ventilation. Early detection and intervention can reduce the complications in these patients.