Obstructive Lung Diseases |

Chronic Obstructive Lung Disease and Bronchiectasis: Single Phenotype of Exacerbations? FREE TO VIEW

Maria João Oliveira, MS; Daniel Coutinho, MS; Daniel Vaz, MS; Maria do Céu Brito, MS
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Centro Hospitalar de Vila Nova de Gaia e Espinho, Arcozelo, Portugal

Chest. 2014;145(3_MeetingAbstracts):413A. doi:10.1378/chest.1834984
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SESSION TITLE: Bronchiectasis Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: Evaluate the characteristics of patients with chronic obstructive pulmonary disease (COPD) and bronchiectasis.

METHODS: Retrospective analysis of patients admitted to the Department of Pulmonology, between 2010 and 2012, with COPD diagnosis. From these, were selected those which coexisted the diagnosis Bronchiectasis. We analyzed the demographic characteristics, FEV1, exacerbation criteria present on admission (dyspnea, wheezing, fever, asthenia, increased sputum, chest radiograph new infiltrates and changes on lung auscultation), type and distribution of bronchiectasis, microbial colonization, length of stay, readmissions and mortality.

RESULTS: We analyzed 183 patients (86.3% men), mean age 66±12 years. Mean FEV1% predicted of 30.2±18.9%. The average number of exacerbation criteria present at admission was 3.96, the most frequent being: dyspnea (87.4%), abnormal lung auscultation (86.4%) and increased sputum (74.9%). The type of bronchiectasis was cylindrical in 41.7% of the patients, cystic 15.1%, varicose 6% and 27.6% of patients had multiple types. 84.4% were bilateral. 18% of patients were colonized by bacteria (63.6% with P. aeruginosa). The mean duration of hospitalization was 10.9±7.0 days, which was higher in patients colonized 15.0vs9.6 (p=0.001). Early readmission (<30 days) was 25.1% and one year readmission was 58.9%. The mortality rate was 9.4%.

CONCLUSIONS: COPD and Bronchiectasis are two different pathologies, which relate each other and can coexist in the same patient. The patients with both pathologies (according to this sample) are elderly, with severe obstruction and bilateral bronchiectasis (mostly cylindrical). Their hospital stay is high (due to the length of stay which can be extended when bacterial colonization is present and the number of frequent readmissions).

CLINICAL IMPLICATIONS: For all these circumstances, when COPD and Bronchiectasis coexist, they should be viewed as a single and more severe phenotype.

DISCLOSURE: The following authors have nothing to disclose: Maria João Oliveira, Daniel Coutinho, Daniel Vaz, Maria do Céu Brito

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