Chest
Volume 140, Issue 5, November 2011, Pages 1130-1137
Journal home page for Chest

Original Research
Obstructive Lung Diseases
Factors Associated With Bronchiectasis in Patients With COPD

https://doi.org/10.1378/chest.10-1758Get rights and content

Background

Previous studies have shown a high prevalence of bronchiectasis in patients with moderate to severe COPD. However, the factors associated with bronchiectasis remain unknown in these patients. The objective of this study is to identify the factors associated with bronchiectasis in patients with moderate to severe COPD.

Methods

Consecutive patients with moderate (50% < FEV1 ≤ 70%) or severe (FEV1 ≤ 50%) COPD were included prospectively. All subjects filled out a clinical questionnaire, including information about exacerbations. Peripheral blood samples were obtained, and lung function tests were performed in all patients. Sputum samples were provided for monthly microbiologic analysis for 6 months. All the tests were performed in a stable phase for at least 6 weeks. High-resolution CT scans of the chest were used to diagnose bronchiectasis.

Results

Ninety-two patients, 51 with severe COPD, were included. Bronchiectasis was present in 53 patients (57.6%). The variables independently associated with the presence of bronchiectasis were severe airflow obstruction (OR, 3.87; 95% CI, 1.38-10.5; P = .001), isolation of a potentially pathogenic microorganism (PPM) (OR, 3.59; 95% CI, 1.3-9.9; P = .014), and at least one hospital admission due to COPD exacerbations in the previous year (OR, 3.07; 95% CI, 1.07-8.77; P = .037).

Conclusion

We found an elevated prevalence of bronchiectasis in patients with moderate to severe COPD, and this was associated with severe airflow obstruction, isolation of a PPM from sputum, and at least one hospital admission for exacerbations in the previous year.

Section snippets

Study Subjects

The study prospectively included 106 consecutive patients diagnosed with COPD, according to international standards, in our specialist outpatient clinic between January 2004 and December 2006. COPD was defined as a postbronchodilator ratio of FEV1/FVC < 70%, adjusted for age and height in a patient with a smoking habit of > 10 pack-years and β2-agonist reversibility on predicted FEV1 of < 15% and/or 200 mL. COPD was defined as moderate if the postbronchodilator FEV1 was ≤ 70% and severe if the

Results

One-hundred six patients with moderate to severe COPD were analyzed. Eight were excluded from the study because of previous diagnoses of bronchiectasis, four were unable to undergo HRCT scan, and two had uninterpretable HRCT scan results. Of the 92 patients remaining in the study (mean age 71.3 [9.3] years; 99% men), 51 (55.4%) had severe COPD and 41 (44.6%) had moderate COPD. Fifty-three patients (57.6%) presented bronchiectasis (72.5% of the subjects with severe COPD and 34.7% of the subjects

Discussion

Based on our results, the presence of a severe airflow obstruction (FEV1 ≤ 50%), a positive culture of a PPM from a sputum sample, and at least one hospital admission for acute exacerbation in the previous year are factors independently associated with bronchiectasis in patients with moderate or severe COPD.

The prevalence of bronchiectasis in patients with moderate to severe COPD in this study was 57.6%; it was primarily of a cylindric type, localized in the lower lobes, with a frequency

Acknowledgments

Author contributions: Dr Martínez-García: contributed to the design of the study and the collection and analysis of the data; he is also the main author of the manuscript.

Dr Soler-Cataluña: contributed to the design of the study, the collection and analysis of the data, and review of the manuscript.

Dr Donat Sanz: contributed to data collection and the writing of the manuscript.

Dr Catalán Serra: contributed to data collection and the writing of the manuscript.

Dr Agramunt Lerma: contributed to

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    Funding/Support: This work was supported in part by a public grant from the Sociedad Valenciana de Neumología.

    Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).

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