Prognostic Value of Bronchiectasis in Patients with Moderate-to-Severe Chronic Obstructive Pulmonary Disease

Martínez-García, Miguel-Ángel; Rosa, David de la; Soler-Cataluña, Juan José; Donat-Sanz, Yolanda; Serra, Pablo Catalán; Lerma, Marco Agramunt; Ballestin, Javier; Sánchez, Irene Valero; Ferrer, Marcela; Dalfo, Anna Roma; Valdecillos, Montserrat Bertomeu

doi:10.1164/rccm.201208-1518oc

Cited by 280 publications

(286 citation statements)

References 39 publications

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“…Although bronchiectasis is a disease recognized with increasing frequency 24 and associated with a poorer prognosis in subjects with moderate to severe COPD, 25 we found that the number of subjects admitted to the ICU for respiratory failure and severe bronchiectasis has tended to diminish in the last decade. The significant increase during the study period in proportions of subjects with obesity was expected.…”

Section: Discussionmentioning

confidence: 66%

Trends in Prevalence and Prognosis in Subjects With Acute Chronic Respiratory Failure Treated With Noninvasive and/or Invasive Ventilation

et al. 2014

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BACKGROUND:The pattern and outcome of noninvasive ventilation (NIV) use in patients with acute or chronic respiratory disease other than COPD is not well known. The aims of this study were to investigate trends over time in underlying respiratory diseases, use of NIV, and outcomes in COPD and non-COPD patients with acute respiratory failure. METHODS: We made a retrospective analysis of data recorded prospectively from 1,113 subjects admitted between 1998 and 2012. RESULTS: Subject diagnoses were distributed as follows: COPD, n ‫؍‬ 568 (51%); bilateral bronchiectasis, n ‫؍‬ 113 (10%); obesity, n ‫؍‬ 166 (15%); chronic diffuse interstitial lung disease, n ‫؍‬ 131 (12%); restrictive pulmonary disease, n ‫؍‬ 113 (10%); and asthma, n ‫؍‬ 22 (2%). The proportion of subjects with bilateral bronchiectasis significantly decreased (OR 0.91, 95% CI 0.865-0.951, P < .001), whereas the proportion of subjects with obesity increased (OR 1.03, 95% CI 1.001-1.063, P ‫؍‬ .049) over time. The use of NIV (OR 1.05, 95% CI 1.010 -1.090, P ‫؍‬ .01) and the proportion of subjects initially treated with NIV (OR 1.05, 95% CI 1.013-1.094, P ‫؍‬ .009) increased significantly in COPD subjects only. Time trend of mortality was not significant (OR 0.98, 95% CI 0.95-1.01, P ‫؍‬ .23), whereas the severity of illness in subjects significantly increased. Transition from NIV to invasive mechanical ventilation (IMV) (OR 2.05, 95% CI 1.36 -3.11, P ‫؍‬ < .001), IMV (OR 10.49, 95% CI 4.88 -10.56, P < .001) and diffuse interstitial lung disease (OR 10.63, 95% CI 5.43-20.83, P < .001) were independently associated with death in the ICU. CONCLUSIONS: Over time, respiratory diseases have changed in non-COPD subjects and trends in the use and efficacy of NIV differ between COPD and non-COPD subjects. Mortality remained stable while the severity of illness in subjects increased. In COPD and non-COPD subjects, transition from NIV to IMV was associated with a poorer prognosis.

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Section: Discussionmentioning

confidence: 66%

Trends in Prevalence and Prognosis in Subjects With Acute Chronic Respiratory Failure Treated With Noninvasive and/or Invasive Ventilation

et al. 2014

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“…Since the bronchiectasis prevalence varies from 4% to 58% in COPD (65,66). In addition, bronchiectasis and COPD overlap syndrome (BCOS), is associated with poor outcomes (67). Despite that chronic cough and sputum production are characteristics of bronchiectasis, they have been suggested as a risk factor for exacerbations of COPD (68,69).…”

Section: Clinical Evidence Of the Efficacy Of Roflumilast In Other Aimentioning

confidence: 99%

Roles of roflumilast, a selective phosphodiesterase 4 inhibitor, in airway diseases

Kawamatawong

2017

J. Thorac. Dis.

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“…Bronchiectasis and COPD often coexist with a varying prevalence amongst study populations (29%‐57%) 22, 23, 24, 25. Both diseases share several pathophysiological features including increased airway inflammation, propensity for exacerbations, distortion of the architecture of the lung parenchyma and bacterial colonisation of the airways.…”

Section: Pathophysiology Of Ncfbmentioning

confidence: 99%

“…A study by Martínez‐García demonstrated worse airflow limitation, increased isolation of potential pathogens, and more frequent hospital admissions in patients with COPD and bronchiectasis compared with patients with COPD alone 24. A follow‐up study from the same group showed that patients with bronchiectasis and COPD had an increased risk of all‐cause mortality 26.…”

Section: Pathophysiology Of Ncfbmentioning

confidence: 99%

Suspecting non-cystic fibrosis bronchiectasis: What the busy primary care clinician needs to know

et al. 2017

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SummaryAimsNon‐cystic fibrosis bronchiectasis (NCFB) is a chronic, progressive respiratory disorder characterised by irreversibly and abnormally dilated airways, persistent cough, excessive sputum production and recurrent pulmonary infections. In the last several decades, its prevalence has increased, making it likely to be encountered in the primary care setting. The aim was to review the clinical presentation and diagnosis of NCFB, with an emphasis on the role of computed tomography (CT).MethodsFor this review, trials and reports were identified from PubMed/Medline and ClinicalTrials.gov from the US NIH and the Cochrane Register of Controlled Trials. The search used keywords: bronchiectasis, non‐cystic fibrosis bronchiectasis, chronic pulmonary infection and computed tomography. No date/language restrictions were used.ResultsNon‐cystic fibrosis bronchiectasis often coexists with other respiratory conditions, such as chronic obstructive pulmonary disease. The prevalence of NCFB is increasing, particularly in women and older individuals, possibly as a result of increased physician awareness and widespread use of CT, which is the gold standard for the diagnosis of NCFB. CT can assist in identifying an underlying cause of NCFB and determining the extent and severity of the disease.DiscussionNon‐cystic fibrosis bronchiectasis should be suspected in the primary care setting in patients with chronic cough, purulent sputum and frequent respiratory infections that tend to resolve slowly or partially. Early diagnosis and determination of the extent and severity of the disease by CT and other tests are critical to establish therapy to improve quality of life and potentially slow progressive decline of lung function in patients with NCFB .

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Prognostic Value of Bronchiectasis in Patients with Moderate-to-Severe Chronic Obstructive Pulmonary Disease

Abstract: Bronchiectasis was associated with an independent increased risk of all-cause mortality in patients with moderate-to-severe COPD.

Cited by 280 publications

References 39 publications

Trends in Prevalence and Prognosis in Subjects With Acute Chronic Respiratory Failure Treated With Noninvasive and/or Invasive Ventilation

Trends in Prevalence and Prognosis in Subjects With Acute Chronic Respiratory Failure Treated With Noninvasive and/or Invasive Ventilation

Roles of roflumilast, a selective phosphodiesterase 4 inhibitor, in airway diseases

Suspecting non-cystic fibrosis bronchiectasis: What the busy primary care clinician needs to know

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