Bronchiectasis Common in COPD Patients with Frequent Flares and Hospitalizations, Study Finds

Bronchiectasis Common in COPD Patients with Frequent Flares and Hospitalizations, Study Finds

People with moderate-to-severe chronic obstructive pulmonary disease (COPD) often develop bronchiectasis, particularly those with a long disease history or flares that lead to at least once hospitalization each year, a study found.

The study, “Characteristics and related factors of bronchiectasis in chronic obstructive pulmonary disease,” was published in the journal Medicine.

COPD is a chronic inflammatory disease characterized by long-term breathing problems and poor airflow.

Several studies have indicated that bronchiectasis is much more common in people with moderate-to-severe COPD than among the general population.

To characterize the incidence and nature of bronchiectasis in COPD patients, researchers in China reviewed the medical records of 133 people, mostly male (62.4%) with an average age of 70.18. All had moderate-to-severe COPD and were admitted to Tianjin Chest Hospital for treatment between 2015 and 2017.

Bronchiectasis was diagnosed via high resolution computed tomography (HRCT) chest scans. COPD severity, patients’ lung function, and their medical history were evaluated.

Investigators also analyzed blood and sputum (mucus expelled by coughing) samples to assess levels of oxygen and carbon dioxide in the blood, and the presence of harmful microbes in the lungs.

Bronchiectasis was found in 43 of these patients (32.3%), who were then divided into a COPD group and COPD with bronchiectasis group.

On average, their forced expiratory volume in one second (FEV1, a measure of lung function) was 37.91%. FEV1 values lower than 50% in COPD patients are indicative of severe disease, and most enrolled in this study had severe COPD (78.2%). The other (21.8%) had moderate disease.

A majority (58.1%) of the roughly one-third of patients with COPD and bronchiectasis (32.3%) had bilateral bronchiectasis, meaning the disease was present in both lungs. The most commonly involved sites were the lower and upper lobes of the left lung, and the middle lobe of the right lung.

Bronchiectasis in COPD patients was found to be associated with a “long medical history, and hospitalization at least once a year due to acute exacerbation of COPD,” the researchers wrote.

Other factors linked with bronchiectasis included the presence of at least one culture of harmful microbes. The most common found in sputum samples from people with both these lung diseases was the bacteria Pseudomonas aeruginosa.

No significant differences in hospitalization length or lung function between COPD patients with and without bronchiectasis were seen.

Investigators also found no significant differences in markers of systemic inflammation and nutritional status between these patient groups, suggesting that “bronchiectasis mainly affects the local airway of COPD patients, but has little effect on the whole body.”

Bronchiectasis is more common in people with moderate-to-severe COPD than the general population, the study concluded, and associated with a longer history of COPD, more frequent hospitalizations due to COPD exacerbations (one or more each year), and the presence of potentially harmful microbes in sputum samples.

“Bronchiectasis should be noted in patients with COPD who often suffer from exacerbation or repeated respiratory infections, especially in those who isolate P. aeruginosa from respiratory specimens,” the researchers wrote.