Impact of Radiographic Bronchiectasis in COPD

Area of Science:

• Pulmonology
• Respiratory Medicine
• Clinical Epidemiology

Background:

• Chronic obstructive pulmonary disease (COPD) and bronchiectasis frequently coexist.
• This emerging COPD-bronchiectasis phenotype is associated with a worse prognosis.
• The impact of bronchiectasis on COPD's natural history requires further clarification.

Purpose of the Study:

• To evaluate the associations between bronchiectasis and the prognosis of COPD patients.
• To clarify the impact of bronchiectasis on the quality of life in COPD patients.

Main Methods:

• Systematic review and meta-analysis of observational studies up to April 2019.
• Analysis of outcomes including exacerbations, lung function, biomarkers, microbial colonization, hospital admissions, and mortality.
• Inclusion of data from 415,257 subjects with COPD.

Main Results:

• Bronchiectasis in COPD patients (6.24%) was associated with increased sputum production, exacerbations, hospital admissions, and mortality.
• Poorer lung function (FEV1/FVC), lower albumin, elevated C-reactive protein, and higher rates of microbial colonization (including P. aeruginosa and H. influenzae) were observed.
• The COPD-bronchiectasis phenotype occurred more frequently in older individuals with lower BMI.

Conclusions:

• Bronchiectasis significantly impacts the natural history, disease course, and outcomes of COPD.
• The combined COPD-bronchiectasis phenotype adversely affects patients' health status and prognosis.
• This meta-analysis confirms the detrimental effects of coexisting bronchiectasis in COPD management.