Clinical items required to define the association of COPD and bronchiectasis | |
1. Age >35 years | |
2. Current or past smoking habit (≥10 pack-years) or other toxic exposure (biomass, industrial, etc.) | |
3. Presence of at least 15 mL of expectorated sputum most of the days | |
4. Presence of purulent sputum most of the days | |
5. Presence of haemoptysis | |
6. Presence of chronic cough and expectoration for at least 3 consecutive months in the last 2 years | |
7. Presence of dyspnoea (mMRC ≥1) in the last 2 years | |
8. History of at least one exacerbation in the previous year | |
9. History of frequent infectious exacerbations (≥2) | |
10. History of at least one severe exacerbation in the last year (hospitalisation or intravenous antibiotic therapy) | |
Radiological items required to define the association of COPD and bronchiectasis | |
11. Lack of airway tapering sign | |
12. Airways visible within 1 cm of the pleural surface | |
13. BE (bronchial dilatation) in at least one pulmonary segment in one lobe | |
14. BE (bronchial dilatation) in more than one pulmonary segment in one lobe | |
15. BE (bronchial dilatation) in one or more pulmonary segments in more than one lobe | |
16. Presence of extensive emphysema | |
17. Extensive bronchial wall thickening | |
18. Presence of diffuse mucus plugging | |
19. Presence of air trapping | |
Functional items required to define the association of COPD and bronchiectasis | |
20. Post-bronchodilator FEV1/FVC <0.7 | |
21. Post-bronchodilator FEV1/FVC <LLN | |
22. A positive BD test excludes the diagnosis of COPD–BE association | |
23. A mixed (restrictive/obstructive) pattern excludes the diagnosis of COPD–BE association | |
24. A history of positive BD test excludes the diagnosis of COPD–BE overlap | |
25. A documented history of asthma excludes the diagnosis of COPD–BE overlap | |
Microbiological items required to define the association of COPD and bronchiectasis | |
26. At least one isolation of PPM in sputum in the last year in steady state | |
27. >1 isolation of PPM in sputum in the last year in steady state | |
28. History of chronic bronchial infection by any PPM in steady state | |
29. Isolation of Pseudomonas aeruginosa in sputum | |
30. No isolation of PPM | |
Pathophysiological items required to define the association of COPD and bronchiectasis | |
31. Blood leukocytosis in stable clinical conditions | |
32. High blood level of C-reactive protein in stable clinical conditions | |
33. High blood level of fibrinogen in stable clinical conditions | |
34. High neutrophil count in sputum in stable clinical conditions | |
35. High eosinophil count in serum in stable clinical conditions |
Participants were asked to grade each item, according to their level of agreement on the necessity for the statement to be part of the COPD–BE association definition. mMRC: modified Medical Research Council; BE: bronchiectasis; FEV1: forced expiratory volume in 1 s; FVC: forced vital capacity; LLN: lower limit of normal; BD: bronchodilation; COPD: chronic obstructive pulmonary disease; PPM: potential pathogenic microorganisms.