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Bronchiectasis in Indian Patients of Chronic Obstructive Pulmonary Disease
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A5036 - Bronchiectasis in Indian Patients of Chronic Obstructive Pulmonary Disease
Author Block: D. P. Bhadoria1, C. Vermani1, G. S. Pradhan2, K. M. Srikant1, R. K. Mummorthy1, K. Goyal1, P. Bhadoria3, P. Bharti1; 1Dept of Medicine and Pulmonary Medicine, Maulana Azad Medical College, New Delhi, India, 2Dept of Radiology and Imaging, Maulana Azad Medical College, New Delhi, India, 3Dept. of Anaesthesia and Intensive Care, Maulana Azad Medical College, New Delhi, India.
RATIONALE
Chronic Obstructive Pulmonary Disease (COPD) and bronchiectasis share common pathophysiological mechanisms, symptoms and susceptibility to recurrent exacerbations due to new or persistent infection. Significant number of COPD patients have bronchiectasis in studies from western population. Due to paucity, we undertook the present work to look for an association of bronchiectasis in Indian patients of COPD.
METHODS:
Consecutive 100 COPD patients were recruited from Chest Clinic of Pulmonary Medicine Department using GOLD guidelines 2017 after ethical clearance from our institution and informed consent from patients. Patients were >35 years of age with smoking history of ≥10 pack years without any acute exacerbation in last six weeks. History, demographic details and anthropometric data were collected using structured performa. High Resolution Computed Tomography (HRCT) chest were performed to detect bronchiectasis.
RESULTS:
Of 100 COPD patients, 91 were males and 09, females. The age of patients (mean ± SD) was 57±7.79 (range 35-71) years and smoking pack years 25.87±11.06 (range 10-60); mean FEV1 45.42±18.92 (range 19-89) % of predicted.
55 COPD patients had bronchiectasis on HRCT chest. None of 5 patients in GOLD1 had bronchiectasis. Bronchiectasis was present in 50% (16/32) of GOLD2, in 58% (22/38) of GOLD3 and in 68% (17/25) of GOLD4 COPD patients. Distribution of bronchiectasis was as follows: lower lobes in 29(52.7%), middle lobes in 2(3.6%), upper lobes in 7(12.7%), lower and middles lobes in 11(20%) and upper and middle lobe in 1(1.81%) and upper lobe and lower in 5(9%) patients. Type of bronchiectasis was as follows: cylindrical in 34(61.8%), cystic in 8(14.5%), tubular in 2(3.6%), mixed in 2(3.6%) and others (fibro-bronchiectasis, tractional bronchiectasis, early bronchiectasis) in 09(16.3%) patients. Patients were categorized as Group A (without bronchiectasis) and Group B (with bronchiectasis). Group B of GOLD4 had more decline in FEV1 compared to Group A (P0.007, independent T-test). There was no difference in age, body mass index and smoking pack years in Group A and B of GOLD2, 3 and 4 (P>0.05). Also there was no difference in FEV1 between Group A and B in GOLD2 and 3 (P>0.05). The frequency of bronchiectasis increased with decreasing FEV1 (or increasing GOLD staging) {p-value 0.04, χ2 – 8.27 (chi-square)}. Both groups were equally symptomatic (P>0.05),
CONCLUSION:
In this study, 55% COPD patients had bronchiectasis on HRCT chest, and clinical and demographic characteristics matched in COPD patients without bronchiectasis. Thus, it seems that COPD and bronchiectasis represent an overlap syndrome.
Author Block: D. P. Bhadoria1, C. Vermani1, G. S. Pradhan2, K. M. Srikant1, R. K. Mummorthy1, K. Goyal1, P. Bhadoria3, P. Bharti1; 1Dept of Medicine and Pulmonary Medicine, Maulana Azad Medical College, New Delhi, India, 2Dept of Radiology and Imaging, Maulana Azad Medical College, New Delhi, India, 3Dept. of Anaesthesia and Intensive Care, Maulana Azad Medical College, New Delhi, India.
RATIONALE
Chronic Obstructive Pulmonary Disease (COPD) and bronchiectasis share common pathophysiological mechanisms, symptoms and susceptibility to recurrent exacerbations due to new or persistent infection. Significant number of COPD patients have bronchiectasis in studies from western population. Due to paucity, we undertook the present work to look for an association of bronchiectasis in Indian patients of COPD.
METHODS:
Consecutive 100 COPD patients were recruited from Chest Clinic of Pulmonary Medicine Department using GOLD guidelines 2017 after ethical clearance from our institution and informed consent from patients. Patients were >35 years of age with smoking history of ≥10 pack years without any acute exacerbation in last six weeks. History, demographic details and anthropometric data were collected using structured performa. High Resolution Computed Tomography (HRCT) chest were performed to detect bronchiectasis.
RESULTS:
Of 100 COPD patients, 91 were males and 09, females. The age of patients (mean ± SD) was 57±7.79 (range 35-71) years and smoking pack years 25.87±11.06 (range 10-60); mean FEV1 45.42±18.92 (range 19-89) % of predicted.
55 COPD patients had bronchiectasis on HRCT chest. None of 5 patients in GOLD1 had bronchiectasis. Bronchiectasis was present in 50% (16/32) of GOLD2, in 58% (22/38) of GOLD3 and in 68% (17/25) of GOLD4 COPD patients. Distribution of bronchiectasis was as follows: lower lobes in 29(52.7%), middle lobes in 2(3.6%), upper lobes in 7(12.7%), lower and middles lobes in 11(20%) and upper and middle lobe in 1(1.81%) and upper lobe and lower in 5(9%) patients. Type of bronchiectasis was as follows: cylindrical in 34(61.8%), cystic in 8(14.5%), tubular in 2(3.6%), mixed in 2(3.6%) and others (fibro-bronchiectasis, tractional bronchiectasis, early bronchiectasis) in 09(16.3%) patients. Patients were categorized as Group A (without bronchiectasis) and Group B (with bronchiectasis). Group B of GOLD4 had more decline in FEV1 compared to Group A (P0.007, independent T-test). There was no difference in age, body mass index and smoking pack years in Group A and B of GOLD2, 3 and 4 (P>0.05). Also there was no difference in FEV1 between Group A and B in GOLD2 and 3 (P>0.05). The frequency of bronchiectasis increased with decreasing FEV1 (or increasing GOLD staging) {p-value 0.04, χ2 – 8.27 (chi-square)}. Both groups were equally symptomatic (P>0.05),
CONCLUSION:
In this study, 55% COPD patients had bronchiectasis on HRCT chest, and clinical and demographic characteristics matched in COPD patients without bronchiectasis. Thus, it seems that COPD and bronchiectasis represent an overlap syndrome.
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