Abstract
According to the GOLD Guidelines, bronchiectasis (BE) is one of the comorbidities of COPD. It seems to have an important impact on the natural history of COPD.
Aims: To determine the impact of coexistent bronchiectasis on COPD outcomes.
Methods: A retrospective single-centre study of COPD patients with Bronchiectasis revealed by chest computed tomography. We compared 2 groups of patients: G1: COPD patients with BE (84 cases, 20%); G2: no BE at CTscan (339 cases, 80%). Clinical, functional and bacteriologic features were analyzed.
Results: The study included 423 COPD patients (mean age 65+/-11 years, 97% males). No significant association was seen between age, BMI, length of hospital stay and the coexistence of BE-COPD. the Patients of G1 have a lower FEV1 (1.24,1.37L;p=0,047), lower forced vital capacity (1.93, 2.15L; p=0.028), a higher capnia (42 vs 38.4 mmHg, p<0,001), higher number of acute exacerbations (AE)/year (3.38, 2.4AE/year; p<0.001) with more hospitalisations in the respiratory department (1.26, 1H/year; p=0.048) and in the ICU (0.27, 0.11;p=0.002). Hospitalisations of G1 are characterized by respiratory acidosis (pH: 7.37 vs 7.4; p<0.001), higher capnia (43.3, 39,9;p=0.005), more infection due to Pyocyanic (10.6, 4%; p=0.04), more frequent need to mechanical ventilation (0.24, 0.08/patient/year; p=0.001) and NIV (p=0.039).
Conclusions: Bronchiectasis in COPD indicates a poor prognosis, especially in terms of exacerbation frequency, isolation of Pyocyanic and severe airway obstruction. Given the prognostic implications of bronchiectasis in COPD, its detection could serve as a guide to a better management of this phenotype.
- Copyright ©the authors 2017
