Bronchiectasis and Chronic Obstructive Pulmonary Disease Overlap Syndrome

Sobala, Ruth; Soyza, Anthony De

doi:10.1016/j.ccm.2021.11.005

Cited by 14 publications

(9 citation statements)

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“…Therefore, it is reasonable to speculate that improving lung function parameters with targeted interventions among Indigenous patients with respiratory disorders will reduce hospital admission rates and length of hospitalisation. Furthermore, Bronchiectasis and COPD overlap syndrome (BCOS) is increasingly recognized [ 55 ]. Although both these conditions share several similar clinical features, the management of these conditions differs; hence, in clinical practice, differentiating if COPD or bronchiectasis is the primary disorder, especially when inhaled pharmacotherapy is considered, is vital.…”

Section: Discussionmentioning

confidence: 99%

Hospital admission rates and related outcomes among adult Aboriginal australians with bronchiectasis – a ten-year retrospective cohort study

Howarth,

Gibbs,

Heraganahally

et al. 2024

BMC Pulm Med

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Background This study assessed hospitalisation frequency and related clinical outcomes among adult Aboriginal Australians with bronchiectasis over a ten-year study period. Method This retrospective study included patients aged ≥ 18 years diagnosed with bronchiectasis between 2011 and 2020 in the Top End, Northern Territory of Australia. Hospital admissions restricted to respiratory conditions (International Classification of Diseases (ICD) code J) and relevant clinical parameters were assessed and compared between those with and without hospital admissions. Results Of the 459 patients diagnosed to have bronchiectasis, 398 (87%) recorded at least one respiratory related (ICD-J code) hospitalisation during the 10-year window. In comparison to patients with a recorded hospitalisation against those without—hospitalised patients were older (median 57 vs 53 years), predominantly females (54 vs 46%), had lower body mass index (23 vs 26 kg/m2) and had greater concurrent presence of chronic obstructive pulmonary disease (COPD) (88 vs 47%), including demonstrating lower spirometry values (forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) (median FVC 49 vs 63% & FEV1 36 vs 55% respectively)). The total hospitalisations accounted for 3,123 admissions (median 4 per patient (IQR 2, 10)), at a median rate of 1 /year (IQR 0.5, 2.2) with a median length of 3 days (IQR 1, 6). Bronchiectasis along with COPD with lower respiratory tract infection (ICD code-J44) was the most common primary diagnosis code, accounting for 56% of presentations and 46% of days in hospital, which was also higher for patients using inhaled corticosteroids (81 vs 52%, p = 0.007). A total of 114 (29%) patients were recorded to have had an ICU admission, with a higher rate, including longer hospital stay among those patients with bronchiectasis and respiratory failure related presentations (32/35, 91%). In multivariate regression model, concurrent presence of COPD or asthma alongside bronchiectasis was associated with shorter times between subsequent hospitalisations (-423 days, p = 0.007 & -119 days, p = 0.02 respectively). Conclusion Hospitalisation rates among adult Aboriginal Australians with bronchiectasis are high. Future interventions are required to explore avenues to reduce the overall morbidity associated with bronchiectasis among Aboriginal Australians.

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Section: Discussionmentioning

confidence: 99%

Hospital admission rates and related outcomes among adult Aboriginal australians with bronchiectasis – a ten-year retrospective cohort study

Howarth,

Gibbs,

Heraganahally

et al. 2024

BMC Pulm Med

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Section: Pharmacologic Treatmentsmentioning

confidence: 99%

“…COPD and bronchiectasis frequently co-exist in patients, so that 54.3% of COPD patients have reported to have bronchiectatic features [ 56 ]. Among bronchiectasis patients, the prevalence of COPD ranged (27% to 69%) in previous studies [ 9 , 56 , 57 ]. These bronchiectasis and COPD overlap syndrome (BCOS) patients have shown to have poorer outcomes, including frequent exacerbation, lower lung function, increased mucus production, and increased mortality [ 11 , 12 , 56 ].…”

Section: Pharmacologic Treatmentsmentioning

confidence: 99%

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Exacerbation Prevention and Management of Bronchiectasis

Choi¹

2023

Tuberc Respir Dis

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Bronchiectasis, which is characterized by irreversibly damaged and dilated bronchi, causes significant symptoms, poor quality of life, and increased economic burden and mortality rates. Despite its increasing prevalence and clinical significance, bronchiectasis was previously regarded as an orphan disease, and ideal treatment of this disease has been poorly understood. The European Respiratory Society and British Thoracic Society have recently published guidelines to assist physicians in the clinical field. Guidelines and reports suggest comprehensive management that includes both non-pharmacological and pharmacological treatment. Physiotherapy and pulmonary rehabilitation are two of the most important non-pharmacologic therapies in bronchiectasis patients; long-term inhaled antibiotics and macrolide therapy have gained significant evidence in reducing exacerbation risk in frequent exacerbators. In this review, we summarize recent updates on bronchiectasis treatment to prevent exacerbation and manage clinical deterioration.

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“…Confirming the exposure history is important to exclude patients with chronic airway obstruction secondary to the bronchiectasis itself. Estimated to be present in approximately 25% of patients with severe COPD, this syndrome causes more chronic infection with Pseudomonas aeruginosa and other bacterial pathogens, more frequent exacerbations, more sputum production, and greater mortality than seen in COPD alone ( 1 ).…”

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confidence: 99%