title: Prognostic value of bronchiectasis in patients with moderate-to-severe chronic obstructive pulmonary disease.
abstract: BACKGROUND
  The prevalence of bronchiectasis is high in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) and it has been associated with exacerbations and bacterial colonization. These have demonstrated some degree of prognostic value in patients with COPD but no information about the relationship between bronchiectasis and mortality in patients with COPD is currently available.
  
  
  OBJECTIVE
  To assess the prognostic value of bronchiectasis in patients with moderate-to-severe COPD.
  
  
  METHODS
  Multicenter prospective observational study in consecutive patients with moderate-to-severe COPD. Bronchiectasis was diagnosed by high-resolution computed tomography scan. A complete standardized protocol was used in all patients covering general, anthrophometric, functional, clinical, and microbiologic data. After follow-up, the vital status was recorded in all patients. Multivariate Cox analysis was used to determine the independent adjusted prognostic value of bronchiectasis.
  
  
  RESULTS
  Ninety-nine patients in Global Initiative for Chronic Obstructive Lung Disease (GOLD) II, 85 in GOLD III, and 17 in GOLD IV stages were included. Bronchiectasis was present in 115 (57.2%) patients. During the follow-up (median, 48 mo [interquartile range, 35-53]) there were 51 deaths (43 deaths in the bronchiectasic group). Bronchiectasis was associated with an increased risk of fully adjusted mortality (hazard ratio, 2.54; 95% confidence interval, 1.16-5.56; P = 0.02).
  
  
  CONCLUSIONS
  Bronchiectasis was associated with an independent increased risk of all-cause mortality in patients with moderate-to-severe COPD.
authors: Pneumology Service, Polytechnic and University La Fe Hospital, Valencia, Spain. mianmartinezgarcia@gmail.com
authors: Miguel-Angel
authors: MA
authors: Martínez-García
authors: David
authors: D
authors: de la Rosa Carrillo
authors: Juan-Jose
authors: JJ
authors: Soler-Cataluña
authors: Yolanda
authors: Y
authors: Donat-Sanz
authors: Pablo Catalán
authors: PC
authors: Serra
authors: Marco Agramunt
authors: MA
authors: Lerma
authors: Javier
authors: J
authors: Ballestín
authors: Irene Valero
authors: IV
authors: Sánchez
authors: Maria Jose
authors: MJ
authors: Selma Ferrer
authors: Anna Roma
authors: AR
authors: Dalfo
authors: Montserrat Bertomeu
authors: MB
authors: Valdecillos
mesh_terms: D000368:Aged; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D001987:Bronchiectasis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D013183:Sputum / Q000382:microbiology; D014057:Tomography, X-Ray Computed