BACKGROUND: COPD and radiographic bronchiectasis frequently coexist but the effect of this on the clinical course of COPD is not fully understood. We determined the impact of bronchiectasis on clinical outcomes in COPD patients, independent of coexisting emphysema and bronchial wall thickening (BWT). METHODS: COPD patients admitted with first exacerbation 1998-2008 were identified retrospectively using ICD10 codes J44.0,1,8,9. Patients with suitable CT scans were graded for severity of bronchiectasis, emphysema and BWT on a 5 point scale (0-absent, 1-minor, 2-mild, 3-moderate, 4-severe). RESULTS: 406 patients (71 ± 11 years, 56% male, FEV1 52 ± 23% predicted) were included; 278 (69%) patients had bronchiectasis: minor, 112 (40%); mild, 81 (29%); moderate, 62 (22%); severe 23 (8%). Bronchiectasis severity correlated with severity of BWT (p < 0.001) but not emphysema (p = 0.090). Bronchiectasis independently determined sputum isolation of Pseudomonas aeruginosa (Odds ratio (OR) 1.39 (95% CI 1.07 to 1.80), p = 0.013) and atypical mycobacteria (OR 2.44 (95% CI 1.04 to 5.69), p = 0.040), annual respiratory admissions (p = 0.044) and inpatient days (p < 0.001), but did not predict survival (p = 0.256). CONCLUSIONS: Radiographic bronchiectasis in COPD patients is associated with increased respiratory infection and hospitalisation, independent of coexisting emphysema and BWT. COPD-related bronchiectasis is therefore an important diagnosis with potential implications for treatment.
BACKGROUND:COPD and radiographic bronchiectasis frequently coexist but the effect of this on the clinical course of COPD is not fully understood. We determined the impact of bronchiectasis on clinical outcomes in COPDpatients, independent of coexisting emphysema and bronchial wall thickening (BWT). METHODS:COPDpatients admitted with first exacerbation 1998-2008 were identified retrospectively using ICD10 codes J44.0,1,8,9. Patients with suitable CT scans were graded for severity of bronchiectasis, emphysema and BWT on a 5 point scale (0-absent, 1-minor, 2-mild, 3-moderate, 4-severe). RESULTS: 406 patients (71 ± 11 years, 56% male, FEV1 52 ± 23% predicted) were included; 278 (69%) patients had bronchiectasis: minor, 112 (40%); mild, 81 (29%); moderate, 62 (22%); severe 23 (8%). Bronchiectasis severity correlated with severity of BWT (p < 0.001) but not emphysema (p = 0.090). Bronchiectasis independently determined sputum isolation of Pseudomonas aeruginosa (Odds ratio (OR) 1.39 (95% CI 1.07 to 1.80), p = 0.013) and atypical mycobacteria (OR 2.44 (95% CI 1.04 to 5.69), p = 0.040), annual respiratory admissions (p = 0.044) and inpatient days (p < 0.001), but did not predict survival (p = 0.256). CONCLUSIONS: Radiographic bronchiectasis in COPDpatients is associated with increased respiratory infection and hospitalisation, independent of coexisting emphysema and BWT. COPD-related bronchiectasis is therefore an important diagnosis with potential implications for treatment.
Authors: Sara Lonni; James D Chalmers; Pieter C Goeminne; Melissa J McDonnell; Katerina Dimakou; Anthony De Soyza; Eva Polverino; Charlotte Van de Kerkhove; Robert Rutherford; John Davison; Edmundo Rosales; Alberto Pesci; Marcos I Restrepo; Antoni Torres; Stefano Aliberti Journal: Ann Am Thorac Soc Date: 2015-12
Authors: James D Chalmers; Stefano Aliberti; Eva Polverino; Montserrat Vendrell; Megan Crichton; Michael Loebinger; Katerina Dimakou; Ian Clifton; Menno van der Eerden; Gernot Rohde; Marlene Murris-Espin; Sarah Masefield; Eleanor Gerada; Michal Shteinberg; Felix Ringshausen; Charles Haworth; Wim Boersma; Jessica Rademacher; Adam T Hill; Timothy Aksamit; Anne O'Donnell; Lucy Morgan; Branislava Milenkovic; Leandro Tramma; Joao Neves; Rosario Menendez; Perluigi Paggiaro; Victor Botnaru; Sabina Skrgat; Robert Wilson; Pieter Goeminne; Anthony De Soyza; Tobias Welte; Antoni Torres; J Stuart Elborn; Francesco Blasi Journal: ERJ Open Res Date: 2016-01-20
Authors: Carlos H Martinez; Yuka Okajima; Andrew Yen; Diego J Maselli; Pietro Nardelli; Farbord Rahaghi; Kendra Young; Gregory Kinney; Charles Hatt; Craig Galban; George R Washko; MeiLan Han; Raúl San José Estépar; Alejandro A Diaz Journal: Acad Radiol Date: 2020-03-23 Impact factor: 3.173