Clinical Features And Prognosis Factors In Patients With COPD Coexist With Bronchiectasis

Objective:Bronchiectasis shows a high prevalence in patients with chronic obstructive pulmonary disease(COPD). The objective of this study is to assess the clinical characteristic and prognostic value of bronchiectasis in patients with COPD in China.Method:Consecutive patients diagnosed with COPD in Shanghai Pulmonary Hospital between January 2009 and December 2013 were collected retrospectively. Clinical records of all patients were reviewed and analyzed. Follow-up data were extracted from the database of follow-up team. Statistical analyses were used to determine the clinical characteristics and prognostic value of bronchiectasis in COPD patients.Result:A total of 896 COPD patients were included. Bronchiectasis was present in 311 patients(34.7%). The variables associated with the presence of bronchiectasis in COPD patients were purulent sputum production(adjusted hazard ratio(HR), 1.51; 95% confidence interval(CI), 1.08-2.11; P = 0.015)and isolation of Pseudomonas aeruginosa(PA) from sputum(HR, 2.93; 95% CI, 1.35-6.37; P = 0.007). 408 patients respondedto the follow-up. During the follow-up(median 21 months [interquartile range 10-39]) there were 75 deaths(39 deaths in the bronchiectasis group). The presence of bronchiectasis(HR, 1.77; 95% CI, 1.02-3.08; P = 0.043)was associated with an increased risk of all-cause mortality in patients with COPD.Conclusion:The presence of bronchiectasis in COPD patients was associated with long duration of symptoms, purulent sputum production and a PA isolated from sputum. Bronchiectasis was an independent risk factor of all-cause mortality in patients with COPD.