Bronchial Infection and Temporal Evolution of Bronchiectasis in Patients With Chronic Obstructive Pulmonary Disease.


Journal

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213

Informations de publication

Date de publication:
01 02 2021
Historique:
received: 12 08 2019
accepted: 20 01 2020
pubmed: 23 1 2020
medline: 29 4 2021
entrez: 23 1 2020
Statut: ppublish

Résumé

Bronchiectasis (BE) impact the clinical course and prognosis of patients with chronic obstructive pulmonary disease (COPD). Yet, the temporal evolution of BE in these patients is unknown. This study seeks to assess the temporal evolution of BE in persons with COPD. 201 moderate-to-severe patients were recruited between 2004 and 2007 and followed up at least every 6 monts (median of 102 months). To investigate the temporal evolution of BE, in 2015 a second high-resolution computed tomography scan (HRCT) was obtained in survivors and compared with the one obtained at recruitment. 99 (49.3%) died during follow-up. The second HRCT could be obtained in 77 patients and showed that (1) in 27.3% of patients BE never developed, in 36.4% they remained stable, in 16.9% they increased in size and/or extension, and in 19.5% new BE emerged; and that (2) the presence of chronic purulent sputum (hazard ratio [HR], 2.8 [95% confidence interval {CI}, 1.3-5.8]), number of hospitalizations due to exacerbatons (HR, 1.2 [95% CI, 1.1-1.5]), and number of pathogenic microorganism (PPM) isolations (HR, 1.1 [95% CI, 1.02-1.3]) were independent risk factors for the progression or development of BE. The presence of chronic purulent sputum production, number of PPMs isolated in sputum, and number of hospitalizations due to exacerbations of COPD are independent risk factors of BE progression in patients with COPD.

Sections du résumé

BACKGROUND
Bronchiectasis (BE) impact the clinical course and prognosis of patients with chronic obstructive pulmonary disease (COPD). Yet, the temporal evolution of BE in these patients is unknown. This study seeks to assess the temporal evolution of BE in persons with COPD.
METHODS
201 moderate-to-severe patients were recruited between 2004 and 2007 and followed up at least every 6 monts (median of 102 months). To investigate the temporal evolution of BE, in 2015 a second high-resolution computed tomography scan (HRCT) was obtained in survivors and compared with the one obtained at recruitment.
RESULTS
99 (49.3%) died during follow-up. The second HRCT could be obtained in 77 patients and showed that (1) in 27.3% of patients BE never developed, in 36.4% they remained stable, in 16.9% they increased in size and/or extension, and in 19.5% new BE emerged; and that (2) the presence of chronic purulent sputum (hazard ratio [HR], 2.8 [95% confidence interval {CI}, 1.3-5.8]), number of hospitalizations due to exacerbatons (HR, 1.2 [95% CI, 1.1-1.5]), and number of pathogenic microorganism (PPM) isolations (HR, 1.1 [95% CI, 1.02-1.3]) were independent risk factors for the progression or development of BE.
CONCLUSIONS
The presence of chronic purulent sputum production, number of PPMs isolated in sputum, and number of hospitalizations due to exacerbations of COPD are independent risk factors of BE progression in patients with COPD.

Identifiants

pubmed: 31967312
pii: 5713998
doi: 10.1093/cid/ciaa069
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

403-410

Commentaires et corrections

Type : CommentIn

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Auteurs

Miguel Ángel Martínez-García (MÁ)

Respiratory Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.

David de la Rosa-Carrillo (D)

Respiratory Unit, Hospital Platón, Barcelona, Spain.

Juan Jose Soler-Cataluña (JJ)

Respiratory Department, Hospital Arnau de Vilanova, Valencia, Spain.

Pablo Catalan-Serra (P)

Respiratory Department, Hospital Arnau de Vilanova, Valencia, Spain.

Marta Ballester (M)

Pneumology Unit, Hospital General de Requena, Valencia, Spain.

Yolanda Roca Vanaclocha (Y)

Radiology Department, Hospital Plató, Barcelona, Spain.

Marcos Agramunt (M)

Radiology Unit, Hospital General de Requena, Valencia, Spain.

Javier Ballestin (J)

Radiology Department, Hospital Arnau de Vilanova, Valencia, Spain.

Alberto Garcia-Ortega (A)

Respiratory Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.

Grace Oscullo (G)

Respiratory Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.

Cristina Navarro-Soriano (C)

Respiratory Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.

Alvar Agusti (A)

Respiratory Institute, Hospital Clinic, University of Barcelona, Instituto de Investigaciones Biomédicas Augist Pi i Sunyer, Centro de Investigaciones biomédicas en red Enfermedades Respiratorias, Madrid, Spain.

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