Mortality Higher in Bronchiectasis Patients Who Also Have COPD

Mortality Higher in Bronchiectasis Patients Who Also Have COPD

A Spanish study of patients with non-cystic fibrosis bronchiectasis (BE) found the mortality rate to be higher among those who also had chronic obstructive pulmonary disease (COPD), than in patients with BE alone.

The study, “Clinical impact of chronic obstructive pulmonary disease on non-cystic fibrosis bronchiectasis. A study on 1,790 patients from the Spanish Bronchiectasis Historical Registry,” was published in the journal PLOS ONE.

Medical records from 1,790 patients with non-cystic fibrosis BE between 2002 and 2011 were analyzed. In total, 158 of the patients also had COPD (8.8%).

In this cohort, patients with COPD tended to be male, older, and had poorer respiratory function with more frequent exacerbations (bouts of worsening of symptoms). No significant differences were observed between the two groups (with or without COPD) concerning growth of bacteria (colonization) in the bronchi, or the types of bacteria present.

Mortality in the COPD group, however, was found to be higher (35.9%) than in patients with non-cystic fibrosis BE alone (19%). The cause of death did not differ between the two groups and it was attributed to respiratory causes in the majority of cases (71.2%).

The diagnosis of COPD in a patient with BE made his or her death 1.77 times more likely than a patient with BE alone.

Patients with COPD had a higher rate of treatment with bronchodilators, inhaled steroids and intravenous antibiotics than patients without COPD, while the use of long-term oral or inhaled antibiotics was similar in the two groups. The authors noted that these therapies are not presently recommended in guidelines for treating COPD, and that their use in this patient group should be studied further.

“Patients with BE related to COPD have the same microbiological characteristics as patients with BE due to other aetiologies. They receive treatment with long term oral and inhaled antibiotics aimed at controlling chronic bronchial colonisation, even though the current COPD treatment guidelines do not envisage this type of therapy. These patients’ mortality is notably higher than that of remaining patients with non-cystic fibrosis BE.” the team wrote.

“Patients with BE and COPD had a significantly higher mortality than those of other BE etiologies. This confirms the impression that these patients form a special phenotype, different from COPD without BE, but also different from the rest of non-CF BE.” the team suggested.

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