Lung Disease Double Whammy

Bronchiectasis in COPD patients may increase risk of death

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Although chronic obstructive pulmonary disease (COPD) can be avoided in many cases, it remains one of the leading causes of death in the United States. COPD patients with another lung condition may have an even higher death risk.

A recent study showed that bronchiectasis—the destruction and widening of large airways in the lungs—may be linked to an increased risk of death in patients with moderate-to-severe COPD.

According to the study's authors, this finding suggests that the presence of bronchiectasis may help doctors forecast patients' outcomes down the road.

By using the treatments available, doctors may be able to effectively treat bronchiectasis and lower the risk of death in patients with COPD, said the lead author in a press statement.

"Quit smoking and seek treatment for your lung disease."

The study was conducted by a team of researchers led by Miguel-Ángel Martínez-García, MD, of La Fe University and Polytechnic Hospital in Valencia, Spain.

COPD is a disease that makes it hard to breath. It is most often caused by smoking. However, in rare cases, nonsmokers may also develop the disease.

Bronchiectasis, which is common in patients with COPD, is usually caused by swelling or infection of the airways in the lungs. The condition is associated with longer, more severe COPD exacerbations (episodes in which the disease gets much worse), more bacteria in mucous and reduced lung function.

Dr. Martínez-García and colleagues already knew that bronchiectasis was associated with these issues in patients with COPD. However, there was no information about the relationship between bronchiectasis and the risk of death in COPD patients.

For this observational study, the researchers followed 201 patients with moderate-to-severe COPD. Of these, 99 patients were in stage II COPD (moderate), 85 were in stage III (severe) and 17 were in stage IV (very severe).

A total of 115 (57.2 percent) of these COPD patients also had bronchiectasis.

During the follow-up period, which lasted about 48 months for each patient, 51 patients died. Of these, 43 had bronchiectasis.

The data showed that bronchiectasis was associated with an increased risk of death in patients with COPD, for a hazard ratio of 2.54.

A hazard ratio explains how much an event happens in one group versus another. In this case, death occurred more often in COPD patients with bronchiectasis than in those without.

According to Dr. Martínez-García, these findings could have an important impact on clinical practice if they are confirmed in further and larger studies.

"Bronchiectasis can be reliably diagnosed with high-resolution CT scanning, and effective treatments are available, potentially reducing the risk of [death] in patients with COPD," he said.

The study was published February 7 in the American Journal of Respiratory and Critical Care Medicine. Funding and disclosure information was not available.

Reviewed by: 
Review Date: 
March 4, 2013
Last Updated:
August 15, 2013