Bronchiectasis as a Comorbidity of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis

Du, Qingxia; Jin, Jianmin; Liu, Xiaofang

doi:10.1016/j.chest.2016.02.106

Cited by 36 publications

(56 citation statements)

References 30 publications

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“…The mean hospitalization of 10.8 days in our series was also higher than that of COPD patients, which tended to be around 7 days [29,30]. With these data in mind, along with the increased prevalence of BE [4,5], the higher incidence of hospitalizations for BE [6,7,13], and the growing evidence of the latter's association with COPD [31][32][33], it is possible that the overall healthcare expenses due to BE are considerably higher than previously thought.…”

Section: Discussionmentioning

confidence: 46%

Cost of Hospitalizations due to Exacerbation in Patients with Non-Cystic Fibrosis Bronchiectasis

et al. 2018

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Background: Knowing the cost of hospitalizations for exacerbation in bronchiectasis patients is essential to perform cost-effectiveness studies of treatments that aim to reduce exacerbations in these patients. Objectives: To find out the mean cost of hospitalizations due to exacerbations in bronchiectasis patients, and to identify factors associated with higher costs. Methods: Prospective, observational, multicenter study in adult bronchiectasis patients hospitalized due to exacerbation. All expenses from the patients’ arrival at hospital to their discharge were calculated: diagnostic tests, treatments, transferals, home hospitalization, admission to convalescence centers, and hospitals’ structural costs for each patient (each hospital’s tariff for emergencies and 70% of the price of a bed for each day in a hospital ward). Results: A total of 222 patients (52.7% men, mean age 71.8 years) admitted to 29 hospitals were included. Adding together all the expenses, the mean cost of the hospitalization was EUR 5,284.7, most of which correspond to the hospital ward (86.9%), and particularly to the hospitals’ structural costs. The adjusted multivariate analysis showed that chronic bronchial infection by Pseudomonas aeruginosa, days spent in the hospital, and completing the treatment with home hospitalization were factors independently associated with a higher overall cost of the hospitalization. Conclusions: The mean cost of a hospitalization due to bronchiectasis exacerbation obtained from the individual data of each episode is higher than the cost per process calculated by the health authorities. The most determining factor of a higher cost is chronic bronchial infection due to P. aeruginosa, which leads to a longer hospital stay and the use of home hospitalization.

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Section: Discussionmentioning

confidence: 46%

Cost of Hospitalizations due to Exacerbation in Patients with Non-Cystic Fibrosis Bronchiectasis

et al. 2018

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“…16 A systematic review and meta-analysis of 14 observational studies in COPD patients found that the presence of bronchiectasis was associated with worse airflow obstruction, isolation of PPM, increased risk of exacerbation and of mortality. 17 …”

Section: Sectionmentioning

confidence: 99%

British Thoracic Society Guideline for bronchiectasis in adults

Hill

Sullivan

Chalmers

et al. 2018

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“…Prevalence of bronchiectasis in people with COPD in this study was 1.9%. A recent metaanalysis 25 that included 14 observational studies found that comorbid bronchiectasis was associated with an increased risk of severe airway obstruction and mortality.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Chronic obstructive pulmonary disease and comorbidities: a large cross-sectional study in primary care

et al. 2017

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BackgroundChronic obstructive pulmonary disease (COPD) is common, and a major cause of morbidity and mortality worldwide. Recent studies suggest that comorbidities of COPD increase the risk of hospitalisation, polypharmacy, and mortality, but their estimated prevalence varies widely in the literature. AimTo evaluate the prevalence of 38 physical and mental health comorbidities in people with COPD, and compare findings with those for people without COPD in a large nationally representative dataset. Design and settingA cross-sectional data analysis on 1 272 685 adults in Scotland from 314 primary care practices. MethodData on COPD, along with 31 physical and seven mental health comorbidities, were extracted. The prevalence of comorbidities was compared between people who did, and did not, have COPD, standardised by age, sex, and socioeconomic deprivation. ResultsFrom the total sample, 51 928 patients had COPD (4.1%). Of these, 86.0% had at least one comorbidity, compared with 48.9% of people without COPD. Of those with COPD, 22.3% had ≥5 comorbid conditions compared with 4.9% of those who did not have COPD (adjusted odds ratio 2.63, 95% confidence interval = 2.56 to 2.70). In total, 29 of the 31 physical conditions and six of the seven mental health conditions were statistically significantly more prevalent in people who had COPD than those who did not. ConclusionPatients with COPD have extensive associated comorbidities. There is a real need for guidelines and health care to reflect this complexity, including how to detect those common comorbidities that relate to both physical and mental health, and how best to manage them. Primary care, which is unique in terms of offering expert generalist care, is best placed to provide this integrated approach.

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Bronchiectasis as a Comorbidity of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis

Abstract: Background

Cited by 36 publications

References 30 publications

Cost of Hospitalizations due to Exacerbation in Patients with Non-Cystic Fibrosis Bronchiectasis

Cost of Hospitalizations due to Exacerbation in Patients with Non-Cystic Fibrosis Bronchiectasis

British Thoracic Society Guideline for bronchiectasis in adults

Chronic obstructive pulmonary disease and comorbidities: a large cross-sectional study in primary care

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