Journal Article

Prognostic Value of Bronchiectasis in Patients with Moderate-to-Severe Chronic Obstructive Pulmonary Disease

Lerma, Marco Agramunt, de la Rosa Carrillo, David, Soler-Cataluña, Juan-Jose, Donat-Sanz, Yolanda, Sánchez, Irene Valero, Ballestín, Javier, Martínez-García, Miguel-Angel, Serra, Pablo Catalán, Valdecillos, Montserrat Bertomeu, Selma Ferrer, Maria Jose, Dalfo, Anna Roma

2013

Overview

The prevalence of bronchiectasis is high in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) and it has been associated with exacerbations and bacterial colonization. These have demonstrated some degree of prognostic value in patients with COPD but no information about the relationship between bronchiectasis and mortality in patients with COPD is currently available. To assess the prognostic value of bronchiectasis in patients with moderate-to-severe COPD. Multicenter prospective observational study in consecutive patients with moderate-to-severe COPD. Bronchiectasis was diagnosed by high-resolution computed tomography scan. A complete standardized protocol was used in all patients covering general, anthrophometric, functional, clinical, and microbiologic data. After follow-up, the vital status was recorded in all patients. Multivariate Cox analysis was used to determine the independent adjusted prognostic value of bronchiectasis. Ninety-nine patients in Global Initiative for Chronic Obstructive Lung Disease (GOLD) II, 85 in GOLD III, and 17 in GOLD IV stages were included. Bronchiectasis was present in 115 (57.2%) patients. During the follow-up (median, 48 mo [interquartile range, 35-53]) there were 51 deaths (43 deaths in the bronchiectasic group). Bronchiectasis was associated with an increased risk of fully adjusted mortality (hazard ratio, 2.54; 95% confidence interval, 1.16-5.56; P = 0.02). Bronchiectasis was associated with an independent increased risk of all-cause mortality in patients with moderate-to-severe COPD.

• Publisher: American Thoracic Society,Oxford University Press
• Subject: Aged / Ambulatory Care Facilities - statistics & numerical data / Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy / Biological and medical sciences / Bronchiectasis - diagnostic imaging / Bronchiectasis - epidemiology / Bronchiectasis - etiology / Chronic obstructive pulmonary disease / Chronic obstructive pulmonary disease, asthma / Comorbidity / Disease Progression / Emphysema / Female / Humans / Incidence / Inflammation / Intensive care medicine / Kaplan-Meier Estimate / Lung diseases / Male / Medical sciences / Mortality / Observational studies / Patients / Pneumology / Prevalence / Prognosis / Proportional Hazards Models / Prospective Studies / Pulmonary arteries / Pulmonary Disease, Chronic Obstructive - complications / Pulmonary Disease, Chronic Obstructive - mortality / Pulmonary Disease, Chronic Obstructive - physiopathology / Respiratory system : syndromes and miscellaneous diseases / Severity of Illness Index / Spain - epidemiology / Sputum - microbiology / Tomography / Tomography, X-Ray Computed