Spanish researchers have discovered that there is a link between and a higher mortality risk among patients with moderate-to-severe chronic obstructive pulmonary disease (COPD). However, this may, in fact, be good news for COPD wellness, as the discovery could mean that if you have COPD, and are suitable for preventive antibiotic treatment; your doctor may be able to identify you more quickly.
Author Miguel-Angel Martinez-Garcia, of the Polytechnic and University La Fe Hospital, Valencia, said in a press statement: ‘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. Bronchiectasis can be reliably diagnosed with high-resolution CT [computed tomography] scanning, and effective treatments are available, potentially reducing the risk of mortality in patients with COPD.’
For the study, the researchers used this high-resolution CT to detect initial signs of bronchiectasis in 201 patients diagnosed with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage II-IV disease between 2004 and 2007. After this, the patients were followed up every three to six months until July 2010. 57.2% (115) of the patients presented with bronchiectasis and had more severe COPD
The results of the study were that these 115 patients were significantly more likely to have potentially pathogenic microorganism isolates in their sputum than patients without bronchiectasis (59.1 vs 20.0%). Over the 48 months of the study, 43 of the 51 patients who died had bronchiectasis. According to multivariate analysis, COPD patients with bronchiectasis were 2.54 times more likely to die than patients without, and a poorer prognosis seemed to also present itself in older patients, and those with lower post-bronchodilator FEV1 or a higher Charlson comorbidity Index score.
According to Martinez-Garcia and colleagues in the American Journal of Respiratory and Critical Care Medicine, ‘The prognostic value of the presence and severity of bronchiectasis could suggest the existence of a new phenotype of COPD patients with bronchiectasis, probably related to the exacerbation and chronic bronchitis phenotypes.’
They concluded, ‘The pathogenic vicious circle of infection-inflammation leading to the formation of bronchiectasis can probably be broken by the early identification of this subgroup of patients with COPD and bronchiectasis and the establishment of early treatment, probably focusing on bronchial colonization by [potentially pathogenic microorganisms].’
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