Abstract
Background: An increased prevalence of hiatus hernia (HH) has been reported in several respiratory diseases. We aimed to evaluate the prevalence of HH by computed tomography (CT) among a well-defined cohort of stable non-cystic fibrosis bronchiectasis patients and determine correlations between HH and disease severity.
Methods: A retrospective observational cohort study in consecutive bronchiectasis patients who had undergone investigation in our institution over an 18-month period was performed. Data was collected on baseline variables, microbiology, lung function and radiology. Imaging was independently assessed by a blinded thoracic radiologist to determine presence of HH and extent of bronchiectatic disease.
Results: 81 patients were found to have confirmed bronchiectasis on high resolution (HRCT) imaging. 29 (35.8%) were confirmed to have HH on CT (mean age 64.4 years, 72.4% females, body mass index 29.4). Of the remaining 57 patients, mean age was 61.6 years, 65.4% females, BMI 26.1. A higher proportion of HH-positive patients had high BMI (p=0.05). HH-positive patients were found to have an increased frequency of cystic bronchiectasis (HH-positive 31.0%, HH-negative 11.5%, p=0.03) and an increased number of bronchiectatic lobes affected (2.62 versus 2.17, p=0.033) compared with HH-negative patients. There was no predilection for any particular lobe. A trend in reduced FEV1% in HH-positive patients was noted (78.6% versus 90.3%, p=0.091) A lower frequency of Haemophilus influenza was observed in HH-positive patients (p=0.089).
Conclusions: In this cohort, HH correlated with increased extent and severity of radiological disease with a trend towards reduced lung function.
- © 2013 ERS