RATIONALE: 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. OBJECTIVES: To assess the prognostic value of bronchiectasis in patients with moderate-to-severe COPD. METHODS: 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. MEASUREMENTS AND MAIN RESULTS: 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). CONCLUSIONS: Bronchiectasis was associated with an independent increased risk of all-cause mortality in patients with moderate-to-severe COPD.
RATIONALE: 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. OBJECTIVES: To assess the prognostic value of bronchiectasis in patients with moderate-to-severe COPD. METHODS: 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. MEASUREMENTS AND MAIN RESULTS: 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). CONCLUSIONS:Bronchiectasis was associated with an independent increased risk of all-cause mortality in patients with moderate-to-severe COPD.
Authors: Wassim W Labaki; Carlos H Martinez; Fernando J Martinez; Craig J Galbán; Brian D Ross; George R Washko; R Graham Barr; Elizabeth A Regan; Harvey O Coxson; Eric A Hoffman; John D Newell; Douglas Curran-Everett; James C Hogg; James D Crapo; David A Lynch; Ella A Kazerooni; MeiLan K Han Journal: Am J Respir Crit Care Med Date: 2017-12-01 Impact factor: 21.405
Authors: Alejandro A Diaz; Thomas P Young; Diego J Maselli; Carlos H Martinez; Ritu Gill; Pietro Nardelli; Wei Wang; Gregory L Kinney; John E Hokanson; George R Washko; Raul San Jose Estepar Journal: Chest Date: 2016-11-24 Impact factor: 9.410
Authors: Samuel Y Ash; Rola Harmouche; Rachel K Putman; James C Ross; Alejandro A Diaz; Gary M Hunninghake; Jorge Onieva Onieva; Fernando J Martinez; Augustine M Choi; David A Lynch; Hiroto Hatabu; Ivan O Rosas; Raul San Jose Estepar; George R Washko Journal: Chest Date: 2017-05-12 Impact factor: 9.410
Authors: Don Hayes; Benjamin T Kopp; Joseph D Tobias; Frederick W Woodley; Heidi M Mansour; Dmitry Tumin; Stephen E Kirkby Journal: Lung Date: 2015-10-01 Impact factor: 2.584
Authors: Germán González; Samuel Y Ash; Gonzalo Vegas-Sánchez-Ferrero; Jorge Onieva Onieva; Farbod N Rahaghi; James C Ross; Alejandro Díaz; Raúl San José Estépar; George R Washko Journal: Am J Respir Crit Care Med Date: 2018-01-15 Impact factor: 21.405