Bronchiectasis progression in patients with chronic obstructive pulmonary disease (COPD) is associated with several preventable risk factors, according to study results published in Clinical Infectious Diseases.

Patients with COPD were prospectively evaluated via high-resolution computed tomography scan (HRCT) and follow-up every 6 months. After 2 years, a second HRCT scan was obtained in survivors and compared with the scan obtained at recruitment. Risk factors for bronchiectasis were then assessed and compared between patients who developed bronchiectasis during that time and patients who did not.

Of the 201 patients included in the initial HRCT scan, 99 died during follow-up. An additional 22 patients were unable to obtain a second HRCT scan, leaving 77 secondary HRCT scans available for analysis. Of these 77 patients, 27.3% had no evidence of bronchiectasis, 36.4% remained stable, 16.9% experienced increases in size and/or extension, and new cases of bronchiectasis emerged in 19.5%.

It was determined that the presence of chronic mucopurulent or purulent sputum (odds ratio [OR], 2.8; 95% CI, 1.3-5.8), the frequency of hospitalization due to COPD exacerbations (OR, 1.2; 95% CI, 1.1-1.5), and the number of potentially pathogenic microorganism isolated in sputum samples (OR, 1.1; 95% CI, 1.02-1.3) were both independent and preventable risk factors for bronchiectasis progression. 


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“This study shows that the temporal evolution of [bronchiectasis] in survivors of a longitudinal cohort of patients with COPD is highly heterogeneous,” the researchers wrote. “[N]either age, gender, body mass index, cumulative smoking exposure, severity of airflow limitation, number of annual clinical visits or sputum samples, macrolide use, inhaled antibiotic use, and Charlson [Comorbidity] Index appear to contribute to [bronchiectasis] progression in COPD patients.”

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Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Martinez-Garcia MA, de la Rosa-Carrillo D, Soler-Cataluña JJ, et al. Bronchial infection and temporal evolution of bronchiectasis in patients with chronic obstructive pulmonary disease [published online January 22, 2020]. Clin Infect Dis. doi:10.1093/cid/ciaa069