PT  - JOURNAL ARTICLE
AU  - Himanshu Singh
AU  - Shahul Khan
AU  - Jack Murrell
TI  - A real world experience of COPD exacerbations and possible association with Bronchiectasis in a medium size teaching hospital in the northwest of England
AID  - 10.1183/1393003.congress-2017.PA4966
DP  - 2017 Sep 01
TA  - European Respiratory Journal
PG  - PA4966
VI  - 50
IP  - suppl 61
4099  - http://erj.ersjournals.com/content/50/suppl_61/PA4966.short
4100  - http://erj.ersjournals.com/content/50/suppl_61/PA4966.full
SO  - Eur Respir J2017 Sep 01; 50
AB  - Admissions due to COPD exacerbations is an issue. A distinct Chronic Obstructive Pulmonary Disease (COPD) phenotype associated with Bronchiectasis is important for therapeutic reasons (1). These patients have greater levels of bronchial inflammation, colonisation of the bronchial mucosa with potentially pathogenic microorganisms (PPM) and a longer duration of acute infectious exacerbations (2). They may possibly have a worse prognosis (2). However the prevalence in COPD varies from 4%-50% (2, 3).Our aim was to identify the recurrent exacerbations for possible interventions and also correlate with Bronchiectasis. We retrospectively analysed patients coded as Infective or Non-infective exacerbation of COPD over a 12 month period at Lancashire teaching hospitals. Sputum results and CT Thorax results in these patients over the last 8 years were reviewed. The total number of admissions = 1376.. Infective, 968 (70%) and non-infective 409 (30%). 1051 patients accounted for 1376 episodes, while 68 (48 – infective, 20- non infective)­­ patients had 3 or more admissions accounting for 267 (19.4% of total) episodes. CT Thorax had been done in 59 patients (44 infective group and 15 non infective) of these 68 patients. 25 (42.3 % ) of these showed Bronchiectasis. 21 of 44 (47%) in the Infective group and 4 of 15 in the Non infective (26.6%) group showed Bronchiectasis. PPM are commoner in the group with bronchiectasis, particularly Pseudomonas and Hemophilus Influenzae. 20% of exacerbations in a year were accounted for by only 68 patients over 12 months. 3 or more admissions in a year should prompt a HRCT and close attention to sputum.