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20-11-2011 | General practice | Article

Bronchiectasis prevalence increased in severe COPD


Free abstract

MedWire News: Patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) have an increased prevalence of bronchiectasis, say Spanish researchers who found that bronchiectasis is linked to, among others, severe airflow obstruction.

Although previous studies have suggested that bronchiectasis is more common in moderate-to-severe COPD, the factors associated with this phenomenon remain unclear, the researchers explain.

Miguel Martínez-García, from Hospital General de Requena in Valencia, and colleagues studied 41 patients with moderate COPD, defined as a forced exploratory volume in 1 second (FEV1) of greater than 50% and less than 70%, and 51 patients with severe COPD, defined as an FEV1 of less than or equal to 50%.

The participants completed a clinical questionnaire, peripheral blood samples were taken, lung function tests were performed, and computed tomography of the chest was used to diagnose bronchiectasis. Sputum samples were collected monthly for 6 months for microbiologic analysis.

The results, published in the journal Chest revealed that bronchiectasis was detected in 57.6% of patients, and was significantly more common in those with severe COPD than in those with moderate COPD, at 72.5% versus 34.7%. A history of tuberculosis was present in 5.4% of patients, while 38.0% had a history of at least one pneumonia episode.

The presence of a potentially pathogenic microorganism in at least one sputum sample was detected in 42.4% of patients, and 21.7% were found to have chronic colonization.

Logistic regression analysis revealed that variables independently associated with bronchiectasis were severe airflow obstruction (odds ratio [OR] 3.87), the isolation of a potentially pathogenic microorganism (OR 3.59), and at least one hospital admission for a COPD exacerbation in the previous year (OR 3.07).

"In conclusion, according to our results from patients with moderate-to-severe COPD, the presence of severe airflow obstruction, the isolation of a potentially pathogenic microorganism in a sputum sample, and the need for at least one hospital admission in the previous year are associated with bronchiectasis," the researchers write.

They continue: "When bronchiectasis is detected in patients who present more severe functional COPD, with potentially pathogenic microorganisms in the bronchial mucosa and exacerbations (particularly serious ones), their prognosis is poorer; this underlines the need for the early identification of the specific phenotype of patients with COPD and bronchiectasis, although further studies are needed to evaluate whether the presence of bronchiectasis worsens the prognosis of patients with COPD."

By Liam Davenport

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