Bronchiectasis, a permanent and progressive dilation of the lung's airways, is common in COPD patients and is associated with longer and more intense exacerbations, more frequent bacterial colonization of the bronchial mucosa, and a greater degree of functional impairment.
"As COPD patients with bronchiectasis have an increased incidence of other known prognostic factors, we hypothesized that bronchiectasis itself would also have prognostic value," said lead author Miguel Ángel Martínez-García, MD, of La Fe University and Polytechnic Hospital in Valencia, Spain. "We found that the presence and severity of bronchiectasis were associated with an increase in all-cause mortality in patients with moderate-to-severe COPD, independent of other known risk factors, including pulmonary function and other comorbidities."
The findings were published online ahead of print publication in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.
The multicenter prospective observational study included 201 consecutive patients with moderate-to-severe COPD; 115 of them (57.2%) had bronchiectasis, which was diagnosed by high-resolution computed tomography (CT) scan of the chest. COPD severity was classified according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria.
During a median 48 months of follow-up, there were 51 deaths, including 43 among the patients with bronchiectasis. In a multivariate analysis adjusted for dyspnea, body mass index, presence of potentially pathogenic microorganisms in sputum,comorbidities, number of severe exacerbations and other potentially confounding factors, bronchiectasis was associated with a significantly increased risk of all-cause mortality (hazard ratio 2.54, 95%CI, 1.16-5.56; p=0.02).Age, Charlson Index, and post-bronchodilator ratio of forced expiratory volume in 1 second were also shown to have prognostic value.
The study had a few limitations, including that some variables that have been shown to predict mortality in COPD were not included in the analysis and exact measurement of the size of the bacterial load in sputum samples was not possible.
"If the prognostic value of bronchiectasis in patients with moderate-to-severe COPD that we found is confirmed in further and larger studies, it would have an important clinical impact," said Dr. Martínez-García, "Bronchiectasis can be reliably diagnosed with high-resolution CT scanning, and effective treatments are available, potentially reducing the risk of mortality in patients with COPD."
About the American Journal of Respiratory and Critical Care Medicine:
With an impact factor of 11.080, the AJRRCM is a peer-reviewed journal published by the American Thoracic Society. It aims to publish the most innovative science and the highest quality reviews, practice guidelines and statements in the pulmonary, critical care and sleep-related fields.
Founded in 1905, the American Thoracic Society is the world's leading medical association dedicated to advancing pulmonary, critical care and sleep medicine. The Society's 15,000 members prevent and fight respiratory disease around the globe through research, education, patient care and advocacy.
Nathaniel Dunford | Source: EurekAlert!
Further information: www.thoracic.org
More articles from Health and Medicine:
Human Stem Cells Predict Efficacy of Alzheimer Drugs
06.12.2013 | Rheinische Friedrich-Wilhelms-Universität Bonn
Recurring memory traces boost long-lasting memories
05.12.2013 | Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE)
International team of scientists develops new feedback method for optimizing the laser pulse shapes used in the control of chemical reactions
In many ways, traditional chemical synthesis is similar to cooking. To alter the final product, you can change the ingredients or their ratio, change the method of mixing ingredients, or change the temperature or pressure of the environment of the ingredients.
Like an accomplished chef, chemists have become very skilled ...
A genetic defect protects mice from infection with influenza viruses
A new study published in the scientific journal PLOS Pathogens points out that mice lacking a protein called Tmprss2 are no longer affected by certain flu viruses.
The discovery was made by researchers from the Helmholtz Centre for Infection Research (HZI) in Braunschweig in collaboration with colleagues from Göttingen and ...
The Light: Global study gets underway with online user survey
Light has a fundamental impact on our sense of well-being and performance. In cooperation with Zumtobel, a supplier of lighting solutions, Fraunhofer IAO has launched a global user survey of lighting quality in offices. The objective is to identify the best lighting conditions for a variety of spaces and lighting ...
Quantum entanglement, a perplexing phenomenon of quantum mechanics that Albert Einstein once referred to as “spooky action at a distance,” could be even spookier than Einstein perceived.
Physicists at the University of Washington and Stony Brook University in New York believe the phenomenon might be intrinsically linked with wormholes, hypothetical features of space-time that in popular science fiction can provide a much-faster-than-light shortcut from one part of the universe to another.
But here’s the catch: One couldn’t actually ...
A star is formed when a large cloud of gas and dust condenses and eventually becomes so dense that it collapses into a ball of gas, where the pressure heats the matter, creating a glowing gas ball – a star is born.
New research from the Niels Bohr Institute, among others, shows that a young, newly formed star in the Milky Way had such an explosive growth, that it was initially about 100 times brighter than it is now. The results are published in the scientific journal, Astrophysical Journal Letters.
The young ...
06.12.2013 | Materials Sciences
06.12.2013 | Life Sciences
06.12.2013 | Life Sciences
05.12.2013 | Event News
04.12.2013 | Event News
12.11.2013 | Event News