The prognostic role of the bronchiectasis in patients with COPD

Background: The presence of bronchiectasis in patients with COPD is considered to be associated with severe airflow obstruction, frequent exacerbation and a higher degree of functional impairment. So, we evaluated the incidence of bronchiectasis on high-resolution computed tomography scan (HRCT) in a longitudinal cohort of COPD patients and its clinical characteristics and prognostic value. Methods: We analyzed 479 COPD patients enrolled in the Korean Obstructive Lung Disease (KOLD) cohort. Patients were divided into two groups based on the presence of bronchiectasis on HRCT. The severity of bronchiectasis was evaluated using the modified Bhalla score. Severe bronchiectasis was defined as modified Bhalla score ≥ 5.5. Results: Bronchiectasis was present in 187 (39.0%) patients. No differences were found between the groups for lung function, dyspnea, exacerbation, and mortality. However, COPD patients with severe bronchiectasis were older with lower BMI, lower serum albumin level, lower FEV1, lower diffusing capacity, higher MMRC and SGRQ score, higher emphysema index, and lower muscle mass. A multivariate Cox regression analysis revealed that age (p Conclusions: Our data support that severe bronchiectasis, not the presence of bronchiectasis was associated with severe airflow obstruction, higher emphysema index, nutritional and functional impairment. Severe bronchiectasis may be considered as a significant prognostic factor in patients with COPD.