Journal de médecine respiratoire

Abstrait

The Association between COPD and Bronchiectasis

Mateen Uzbeck

Introduction: An association between chronic Obstructive Pulmonary Disease (COPD) and bronchiectasis has been observed. However, the incidence of this association is variable. The current use of high-resolution Chest Thoracic (CT) scans in patients with COPD has contributed to its demonstration. It is comorbidity or even an overlap syndrome. The aim of this study is to determine the characteristics of bronchiectasis in patients with COPD at the Annaba University Hospital in Algeria.

Subjects and Methods: We prospectively included patients hospitalized at the Annaba University Hospital in Algeria between 1st January, 2013 to 31st December, 2015. All patients were hospitalized for an exacerbation of COPD. One hundred and twelve patients (108 men and 04 women) were enrolled in this study. These patients were classified into two groups: G1 (COPD without bronchiectasis) and G2 (COPD with bronchiectasis). The parameters considered for both the groups were the length of hospitalization, comorbidities as per the Charlson index, number of exacerbations in the previous year, quality of life assessed by the Saint Georges questionnaire, a spirométrie, and C. reactive protein (CRP). The diagnosis of exacerbation, bronchiectasis, and COPD was made. The data collected were statistically analyzed using SPSS/version 16. Parametric data were expressed as mean ± SD, and non-parametric data were expressed as the number and percentage of the total. In all tests, a p-value <0.05 was considered significant. Multivariate logistic regression analysis was performed for statistically significant variables.

Results and Discussion: One hundred and twelve patients (108 men and 04 women) were included in the study. The demographic characteristics of the patients were: age (69.49 years ± 8.15), smoking (53.21 ± 48 p/y), and FEV1 (42.55 ± 18.90 l/s). Of the 112 cases included, 21 had COPD associated with bronchiectasis (18.75%). This bronchiectasis was of cylindrical type in the majority of patients, i.e., 17 (80.95%), saccular in 03 cases (14.28%), and mixed in only one case (04.77%). Lesions were bilateral in 16 patients (76.19%) and unilateral in 05 patients (23.81%). FEV1 in the COPD group associated with bronchiectasis was more severe (48.7 ± 6 l/s vs. 40.2 ± 3 l/s) (OR=4.3187; 95% C.I =2.6301 - 6.8740; p <0.017). Furthermore, we noted that the length of hospitalization, the exacerbations during the past year, the CRP rate, the total score of the Saint Georges questionnaire, and the sputum purulence were statistically significant variables with an Odds Ratio significant in the COPD bronchiectasis association

Conclusion: The diagnosis of bronchiectasis should be more efficient in patients with COPD with a severe respiratory deficit, purulent sputum, accelerated CRP, and deterioration in the quality of life.