COPD-related Bronchiectasis; Independent Impact on Disease Course and Outcomes

Abstract

Radiographic bronchiectasis in COPD patients is associated with increased respiratory infection and hospitalisation, independent of coexisting emphysema and BWT. COPD-related bronchiectasis is therefore an important diagnosis with potential implications for treatment.

Clinical Characteristics of Patients With Chronic Obstructive Pulmonary Disease With Comorbid Bronchiectasis: A Systemic Review and Meta-analysis

“…In the study by Gatheral et al 4 HRCT was not performed for each enrolled patient, which might lead to underestimation of the prevalence of bronchiectasis, although the authors had confirmed that there was no underdetection of bronchiectasis in their study. As the study by Gatheral et al 4 had a significant weightage in meta-analysis, a sensitivity analysis was carried out for five studies excluding the study by Gatheral et al 4 The sensitivity analysis showed that the meta-analysis results on age, sex, daily sputum production, lung function, and PPM isolation did not change after excluding the study by Gatheral et al (Figures S12-S18).…”

“…After reviewing the abstracts and full texts, 12 manuscripts about bronchiectasis in patients with COPD were found. 1,4,6,[11][12][13][14][15][16][17]21,22 Of those, six studies met the inclusion criteria, which included patients with COPD and comorbid bronchiectasis (n=550) and patients with COPD and without comorbid bronchiectasis (n=331). 1,4,7,[11][12][13] The flow diagram of the database search is represented in Figure 1.…”

“…HRCT was used to diagnose bronchiectasis in all studies, except in the study by Gatheral et al 4 wherein a part of patients were diagnosed with bronchiectasis using CT images of 2-3 mm slice thickness (134 patients out of 406 patients, 33%) or 5-7 mm slice thickness (106 patients out of 406 patients, 26%). In their study, the comparative analysis of results of CT images with different slice thicknesses showed no underdetection of abnormalities in thicker CT sections; therefore, their analysis was performed irrespective of the used CT slice thickness.…”

“…3,10 However, in previous studies, controversial results on clinical outcomes, such as lung function and exacerbations, have been reported with relatively small patient populations (44-118 patients). 1,4,7,9,10,[11][12][13][14][15][16][17] Hence, the present meta-analysis was aimed at summarizing the reports on the comorbidity of bronchiectasis and COPD and further clarifying the impact of bronchiectasis on patients with COPD.…”

“…Several studies have revealed a high prevalence of bronchiectasis in patients with COPD, ranging from 20% to 69%. [1][2][3][4] In the 2014 Global initiative for chronic Obstructive Lung Disease (GOLD) guidelines, bronchiectasis was for the first time defined as a comorbidity of COPD, and this change has been retained in the 2015 update, 5 which emphasizes the influence of bronchiectasis in the natural history of COPD.…”