A study of more than 7,600 current and former smokers found that suspected bronchiectasis is associated with a heightened risk of all-cause mortality, even without the presence of chronic obstructive pulmonary disease (COPD).
The study is published in the Annals of Internal Medicine.
According to the authors, these findings support including lung imaging as a tool for clinically defining bronchiectasis and for COPD workup to improve patient care.
Bronchiectasis, a clinical condition characterized by the pathologic widening of airways and repeated infection and inflammation cycles resulting in lung structural damage, often occurs in adults with COPD—a condition mainly caused by exposure to cigarette smoking in the United States.
Incidental bronchiectasis is found in 12 to 30% of adults with a history of smoking in CT images. However, whether incidental bronchiectasis plus symptoms—termed suspected bronchiectasis—is associated with increased mortality in adults with a history of smoking, even without a COPD diagnosis, is unknown.
In a secondary analysis, researchers from Brigham and Women’s Hospital used data collected from the COPDGene (Genetic Epidemiology of Chronic Obstructive Pulmonary Disease) study, a study of patients with COPD and non-COPD control participants, to determine the association between suspected bronchiectasis and mortality in adults with normal spirometry, preserved ratio impaired spirometry, and obstructive spirometry.
Among 7,662 non-Hispanic Black or White adults, aged 45 to 80 years, with 10 or more pack-years of smoking history, 17.6% had suspected bronchiectasis. During a median follow-up of 11 years, 27.3% of participants died. The presence of suspected bronchiectasis was associated with a 15% higher risk for all-cause mortality.
The authors did not find evidence that in patients without COPD, bronchiectasis on CT images per se (ie, without accompanying clinical manifestations) definitely increased mortality risk.
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