Bronchiectasis In COPD Patients Research Articles

Clinico demographic profile of patients with bronchiectasis – A cross sectional study

Bronchiectasis (BE) is a common but neglected chronic lung disease. Most epidemiological data are limited to cohorts from Europe and the USA, with few data from low income and middle income countries “Bronchiectasis” is a chronic debilitating respiratory condition, natural history of Bronchiectasis is variable, some patients have only a few chest infections per year with no disease progression overtime, while others have more frequent prolonged infective episodes and progress more quickly to respiratory failure with an associated increase in risk of death.A vicious cycle of infection and inflammation exists in damaged airways with patient suffering from persistent cough, purulent sputum production, recurrent chest infections and general malaise, associated with increased morbidity and reduced quality of life and socioeconomic, cost of long term management is significant.162 CT confirmed adult patients≥ 18 years were included in the study, data of patients were retrieved demography, clinical features, causative factors, spirometry and imaging reports were studied and analysed.162 adult patients were included in the study. Males (54%) and more than 50 years age group population [64%] was predominantly affected. 58% were non-smokers.Chronic cough (100%) with sputum production (86%) and fatigue (78%) were the most common symptoms, digital clubbing and crackles were the most common examination findings. Dominant cause of BE was post infection (46%) followed by COPD (20%), ABPA (10%) and miscellaneous causes. Obstructive abnormality (42%) was the most common spirometric pattern observed. Higher incidence of cystic BE (57%) was found in our study.Patients > 50 years and males were predominantly affected. Most of the study population had never smoked. Most common symptom found was chronic productive cough and fatigue. Etiology of BE is heterogeneous. Post Tuberculosis BE variety was common. BE in COPD patients was not less common. Central Bronchiectasis was not uncommon.

Relationship between clinical and radiological signs of bronchiectasis in COPD patients: Results from COSYCONET

Bronchiectasis (BE) might be frequently present in COPD but masked by COPD symptoms. We studied the relationship of clinical signs of bronchiectasis to the presence and extent of its radiological signs in patients of different COPD severity.Visit 4 data (GOLD grades 1–4) of the COSYCONET cohort was used. Chest CT scans were evaluated for bronchiectasis in 6 lobes using a 3-point scale (0: absence, 1: ≤50%, 2: >50% BE-involvement for each lobe).1176 patients were included (61%male, age 67.3y), among them 38 (3.2%) with reported physicians’ diagnosis of bronchiectasis and 76 (6.5%) with alpha1-antitrypsin deficiency (AA1D). CT scans were obtained in 429 patients. Within this group, any signs of bronchiectasis were found in 46.6% of patients, whereby ≤50% BE occurred in 18.6% in ≤2 lobes, in 10.0% in 3–4 lobes, in 15.9% in 5–6 lobes; >50% bronchiectasis in at least 1 lobe was observed in 2.1%. Scores ≥4 correlated with an elevated ratio FRC/RV. The clinical diagnosis of bronchiectasis correlated with phlegm and cough and with radiological scores of at least 3, optimally ≥5.In COPD patients, clinical diagnosis and radiological signs of BE showed only weak correlations. Correlations became significant with increasing BE-severity implying radiological alterations in several lobes. This indicates the importance of reporting both presence and extent of bronchiectasis on CT. Further research is warranted to refine the criteria for CT scoring of bronchiectasis and to determine the relevance of radiologically but not clinically detectible bronchiectasis and their possible implications for therapy in COPD patients.

Prevalence of Bronchiectasis in COPD Patients

Prevalence of Bronchiectasis in COPD Patients

Erratum: Bronchiectasis in COPD patients: more than a comorbidity? [Corrigendum

[This corrects the article on p. 1401 in vol. 12, PMID: 28546748.].

Quantitative computed tomography features and clinical manifestations associated with the extent of bronchiectasis in patients with moderate-to-severe COPD.

BackgroundFew studies have investigated the quantitative computed tomography (CT) features associated with the severity of bronchiectasis in COPD patients. The purpose of this study was to identify the quantitative CT features and clinical values to determine the extent of bronchiectasis in moderate-to-severe COPD patients.MethodsA total of 127 moderate-to-severe COPD patients were selected from the cohort of COPD in Dusty Areas (CODA). The study subjects were classified into three groups according to the extent of bronchiectasis on CT: no bronchiectasis, mild bronchiectasis, and moderate-to-severe bronchiectasis. The three groups were compared with respect to demographic data, symptoms, medical history, serum inflammatory markers, pulmonary function, and quantitative CT values.ResultsAmong 127 moderate-to-severe COPD subjects, 73 patients (57.5%) were detected to have bronchiectasis, 51 patients (40.2%) to have mild bronchiectasis, and 22 patients (17.3%) to have moderate-to-severe bronchiectasis. Compared with COPD patients without bronchiectasis, those with bronchiectasis were older and had higher frequency of prior tuberculosis, lower prevalence of bronchodilator reversibility (BDR), and more severe air trapping (P < 0.05). Moderate-to-severe bronchiectasis patients had lower body mass index (BMI), higher frequency of prior tuberculosis, lower prevalence of BDR, worse pulmonary function, and more severe air trapping (P < 0.05) than those in the mild bronchiectasis group.ConclusionModerate-to-severe bronchiectasis was associated with a history of pulmonary tuberculosis, lower BMI, severe airflow obstruction, and lower BDR in moderate-to-severe COPD patients. Quantitative analysis of CT showed that severe air trapping was associated with the extent of bronchiectasis in these patients.

The Correlation Between Airway Obstruction Severity and Low Attenuation Volume With Bronchiectasis in COPD

SESSION TITLE: Medical Imaging: New Approaches to Old Technologies SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: To determine the correlations of emphysema measured by automated lung parenchyma analysis software (%LAV) and pulmonary function tests with bronchiectasis measured by Bhalla score in COPD patients. METHODS: It is a retrospective study of 108 COPD exacerbation patients admitted to hospital during 2014 - 2016. Emphysema quantification (%LAV) of total lungs, left, right lung and according to pulmonary fields, was measured by syngo InSpace Lung Parenchyma software in 128 detectors HRCT Siemens somatom during full inspiration. Respiratory function test FVC, FEV1 and FEV1/FVC have been measured and interpreted according to ERS/ATS guideline.Bronchiectasis was quantified with Bhalla score (B). For analysis of data SPS20, Pearson correlation (R), Anova were used. RESULTS: There is a good correlation between B and FEV1 with R=0.21 , P<0.009. There is a significant statistical changes between mean scores of two groups of bronchiectasis 0-15 and 16 - 25 points according to mean FEV1 values of 30.7 and 44 respectively with a P< 0.02 There is a significant statistical changes between mean scores of bronchiectasis 20.4; 19.9; 16 according to the %LAV classified in 3 categories <23.5;23.6-40;>40 respectively with P<0.035 CONCLUSIONS: There is an important correlation between airway obstruction and %LAV severity with bronchiectasis score. This correlation show that bronchiectasis is a finding of COPD obstruction severity and advanced disease CLINICAL IMPLICATIONS: The presence of bronchiectasis in COPD patients is a finding of obstruction severity which help us to determine the different approach according to the antibiotic, bronchodilatator choices and follow up DISCLOSURE: The following authors have nothing to disclose: Eritjan Tashi, Sofiela Telo, Eugerta Dilka, Esmeralda Nushi, Alma Teferici, Dafina Todri, Oltion Sina, Jetmira Shehu, Serxho Golgota, Eliana Avllai, Perlat Kapisyzi No Product/Research Disclosure Information

Bronchiectasis in COPD patients: more than a comorbidity?

Computed tomography scan images have been used to identify different radiological COPD phenotypes based on the presence and severity of emphysema, bronchial wall thickening, and bronchiectasis. Bronchiectasis is defined as an abnormal dilation of the bronchi, usually as a result of chronic airway inflammation and/or infection. The prevalence of bronchiectasis in patients with COPD is high, especially in advanced stages. The identification of bronchiectasis in COPD has been defined as a different clinical COPD phenotype with greater symptomatic severity, more frequent chronic bronchial infection and exacerbations, and poor prognosis. A causal association has not yet been proven, but it is biologically plausible that COPD, and particularly the infective and exacerbator COPD phenotypes, could be the cause of bronchiectasis without any other known etiology, beyond any mere association or comorbidity. The study of the relationship between COPD and bronchiectasis could have important clinical implications, since both diseases have different and complementary therapeutic approaches. Longitudinal studies are needed to investigate the development of bronchiectasis in COPD, and clinical trials with treatments aimed at reducing bacterial loads should be conducted to investigate their impact on the reduction of exacerbations and improvements in the long-term evolution of the disease.

Bronchiectasis as a Comorbidity of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis.

BackgroundBronchiectasis revealed by chest computed tomography in COPD patients and its comorbid effect on prognosis have not been addressed by large-sized studies. Understanding the presence of bronchiectasis in COPD is important for future intervention and preventing disease progression.MethodsObservational studies were identified from electronic literature searches in Cochrane library, PubMed, ScienceDirect databases, American Thoracic Society and European Respiratory Society meeting abstracts. A systematic review and meta-analysis of studies was performed to summarize the factors associated with bronchiectasis in COPD patients. Primary outcomes included the risks for exacerbation frequency, isolation of a potentially pathogenic microorganism, severe airway obstruction and mortality. Odds ratios (ORs) were pooled by random effects models.ResultsFourteen observational studies were eligible for the study. Compared with COPD without bronchiectasis, comorbid bronchiectasis in COPD increased the risk of exacerbation (1.97, 95% CI, 1.29–3.00), isolation of a potentially pathogenic microorganism (4.11, 95%CI, 2.16–7.82), severe airway obstruction (1.31, 95% CI, 1.09–1.58) and mortality (1.96, 95% CI, 1.04–3.70).ConclusionsThe presence of bronchiectasis in patients with COPD was associated with exacerbation frequency, isolation of a potentially pathogenic microorganism, severe airway obstruction and mortality.

Bronchiectasis in COPD: A New Phenotype of COPD with Particular Attention

Bronchiectasis in Chronic obstructive pulmonary disease (COPD) has been recognized as a potential new phenotype of COPD in recent years due to different clinical presentation, prognosis and treatment response. Broad application of CT scan significantly increased identification of bronchiectasis in COPDpatients. Although the exact mechanism of bronchiectasis development in COPD is lacking, the chronic airway inflammation, colonization of particular bacteria strain such as P. aeruginosa and continuous airway reconstruction may proceed to airway damage and following bronchiectasis. The significance of identifying bronchiectasis in COPD patients is to improve patients’ management through more individualized treatment regimen. Given the poor prognosis in COPD patients with bronchiectasis and limited evidenced based clinical experience, it is therefore essential to have high quality clinical trials conducted in this group of patients.

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

Background: COPD and radiographic bronchiectasis frequently coexist but the effect of this on the clinical course of COPD is not fully understood. We determined the impact of bronchiectasis on clinical outcomes in COPD patients, independent of coexisting emphysema and bronchial wall thickening (BWT). Methods: COPD patients admitted with first exacerbation 1998–2008 were identified retrospectively using ICD10 codes J44.0,1,8,9. Patients with suitable CT scans were graded for severity of bronchiectasis, emphysema and BWT on a 5 point scale (0-absent, 1-minor, 2-mild, 3-moderate, 4-severe). Results: 406 patients (71 ± 11 years, 56% male, FEV1 52 ± 23% predicted) were included; 278 (69%) patients had bronchiectasis: minor, 112 (40%); mild, 81 (29%); moderate, 62 (22%); severe 23 (8%). Bronchiectasis severity correlated with severity of BWT (p < 0.001) but not emphysema (p = 0.090). Bronchiectasis independently determined sputum isolation of Pseudomonas aeruginosa (Odds ratio (OR) 1.39 (95% CI 1.07 to 1.80), p = 0.013) and atypical mycobacteria (OR 2.44 (95% CI 1.04 to 5.69), p = 0.040), annual respiratory admissions (p = 0.044) and inpatient days (p < 0.001), but did not predict survival (p = 0.256). Conclusions: 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.

P218 Prevalence of bronchiectasis in COPD patients in a general respiratory clinic

IntroductionThere is increasing recognition that radiological bronchiectasis is present in many patients with COPD. However, estimated prevalence varies from 4% (Agusti, Respir Res; 2010) to 50% (Patel, AJRCCM; 2004), with...

P176 COPD-Related Bronchiectasis; A Real Clinical Entity with Impact on Disease Course and Outcomes

Introduction and ObjectivesNon-CF bronchiectasis is defined as ‘symptoms of persistent or recurrent bronchial sepsis related to irreversibly damaged and dilated bronchi’ [BTS guidelines 2010]. Radiographic evidence of ‘damaged and dilated...

Bronchiectasis in COPD patients

BackgroundCOPD and brochiectasis are characterized by fixed airway obstruction and chronic cough. The finding of bronchiectasis on HRCT scan in the patient with COPD may indicate the presence of more advanced airway dysfunction, frequent exacerbation and bacterial colonization. ObjectiveThe aim of this study to evaluate the incidence of bronchiectasis on high resolution computed tomography (HRCT) scanning in patients with moderate and severe COPD, and to relate this with the presence of lower airway bacterial colonization, exacerbation frequency, severity. Patients and methodsThis study was carried out on 69 patients diagnosed with COPD. All cases were subjected to through history taking, lung function test, sputum culture, HRCT scan of the chest to diagnose bronchiectasis, All the test were performed in a stable phase. Results69 COPD patients, 32 patients had moderate COPD, 37 patients had severe COPD, 33 patients (47,8%) presented with brochiectasis, (31.3%) of the patients with moderate COPD and 62.2% of the patients with severe COPD with statistically significant difference, the more severe functional impairment (FEV1⩽50%) the greater prevalence of brochiectasis, also the greater bacterial colonization and more exacerbation were associated with the presence of brochiectasis.