Obstructive Lung Diseases: COPD |

Clinical Characteristics of Patients With Chronic Obstructive Pulmonary Disease With Comorbid Bronchiectasis: A Systemic Review and Meta-analysis FREE TO VIEW

Yingmeng Ni, MD; Guochao Shi, MD
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Shanghai Jiaotong University School of Medicine, Shanghai Ruijin Hospital, Shanghai, China

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

Chest. 2016;149(4_S):A344. doi:10.1016/j.chest.2016.02.359
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SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, April 17, 2016 at 09:45 AM - 11:15 AM

PURPOSE: In Global initiative for chronic Obstructive Lung Disease (GOLD) guidelines 2014, bronchiectasis was defined as a comorbidity of chronic obstructive pulmonary disease (COPD), which emphasizes the influence of bronchiectasis in the natural history of COPD. The present meta-analysis was aimed to summarize the impact of bronchiectasis on patients with COPD.

METHODS: Databases including Embase, PubMed, and the Cochrane Central Register of Controlled Trials were searched comprehensively, to identify all relevant human clinical studies published until August 2014. Bronchiectasis was confirmed either by computed tomography or high resolution computed tomography. One or more clinicopathological or demographical characteristics including age, gender, smoking history, daily sputum production, exacerbations, inflammatory biomarkers, lung function, and colonization of potentially pathogenic microorganisms (PPM) were compared between COPD patients with and without bronchiectasis.

RESULTS: Six observational studies with 881 patients were included in the meta-analysis. The mean prevalence of bronchiectasis in patients with COPD was 54.3%, ranged from 25.6 to 69%. Coexistence of bronchiectasis and COPD happened more often in male patients with longer smoking history. Patients with COPD and comorbid bronchiectasis had more daily sputum production, more frequent exacerbation, poorer lung function, higher level of inflammatory biomarkers, more chronic colonization of PPM, and higher rate of Pseudomonas aeruginosa (P. aeruginosa) isolation.

CONCLUSIONS: Despite of heterogeneity between included studies and detectable publication bias, this meta-analysis demonstrated the impact of bronchiectasis in patients with COPD in all directions, indicating that coexistence of bronchiectasis should be considered as a pathological phenotype of COPD, which may have a predictive value.

CLINICAL IMPLICATIONS: Anatomical airway abnormalities of bronchiectasis in patients with COPD are best considered a phenotype of the COPD disease spectrum, and when managed with these patients, some treatments for bronchiectasis exacerbation, such as inhaled antibiotics, including antipseudomonal agents should be considered, but with a shorter course.

DISCLOSURE: The following authors have nothing to disclose: Yingmeng Ni, Guochao Shi

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