Chest Infections: Chest Infections: Bronchieactasis |

Bronchiectasis as a Comorbidity of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis FREE TO VIEW

Qingxia Du; Jianmin Jin; Xiaofang Liu; Yongchang Sun
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Beijing Tongren Hospital, Capital Medical University, Beijing, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A101. doi:10.1016/j.chest.2016.02.106
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SESSION TITLE: Chest Infections: Bronchieactasis

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Bronchiectasis revealed by chest computed tomography in COPD patients and its comorbid effect on prognosis have not been addressed by large-sized studies. Understanding the presence of bronchiectasis in COPD is important for future intervention and preventing disease progress.

METHODS: Observational studies were identified from electronic literature searches in Cochrane library, Pubmed, Sciencedirect databases, American Thoracic Society and European Respiratory Society meeting abstracts. A systematic review and meta-analysis of studies was performed to summarize the factors associated with bronchiectasis in patients with COPD. Primary outcomes included the risks of exacerbation frequency, isolation of a potentially pathogenic microorganism, severe airway obstruction and mortality. Odds ratios (ORs) were pooled by random effects models.

RESULTS: Fourteen observational studies were eligible for the study. Compared with COPD without bronchiectasis, comorbid bronchiectasis increased the risk for exacerbation (1.97, 95% CI, 1.29-3.00), isolation of a potentially pathogenic microorganism (4.11, 95%CI, 2.16-7.82), severe airway obstruction (1.31, 95% CI, 1.09-1.58) and mortality (1.75, 95% CI, 1.14-2.68).

CONCLUSIONS: The presence of bronchiectasis in patients with COPD was associated with exacerbation frequency, isolation of a potentially pathogenic microorganism, severe airway obstruction and mortality. These associations suggest potential usefulness of screening for bronchiectasis in COPD patients for better interventions, especial in patients with advanced COPD or susceptible to frequent exacerbations.

CLINICAL IMPLICATIONS: This study adds to the fast growing evidence of the association between bronchiectasis and poor outcomes in COPD, which has very important implications for our current practice and approach to the evaluation and management of COPD. More importantly, our study provides data supporting chest CT evaluation in the care of COPD patients, especial for those with severe disease and susceptible to exacerbations.

DISCLOSURE: The following authors have nothing to disclose: Qingxia Du, Jianmin Jin, Xiaofang Liu, Yongchang Sun

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