Relationship between the presence of bronchiectasis and acute exacerbation in Thai COPD patients

Figures & data

Table 1 Demographic and baseline details of subjects, including symptoms and functional characteristics

Patients’ characteristics	Non-frequent exacerbation (n=43)	Frequent exacerbation (n=29)	p-value
Gender, male (female)	42 (1)	23 (6)	0.015
Age (years)a	73.39 (60.0–85.0)	70.96 (59.0–82)	0.264
Post-bronchodilator	65.38 (43.0–88.0)	51.69 (30.0–78.0)	0.007
FEV1% predicteda
CAT scorea	11.0 (2–32)	20.5 (3–37)	0.003
mMRCa	1.0 (1–2)	2.0 (1–3)	0.002

Notes:

a Median and IQR. Data are presented as median, IQR and proportion (%). The statistical significance was determined by p-value <0.05.

Abbreviations: CAT, COPD assessment test; FEV₁, forced expiratory volume in 1 second; IQR, interquartile range; mMRC, modified Medical Research Council Dyspnea Scale.

Table 2 Association between bronchiectasis, gender, severe COPD symptoms (CAT ≥10), more dyspnea, severity of airflow limitation and frequent COPD exacerbation (≥2 in the past year) and/or hospitalized exacerbation in the past year

Variables	Univariate analysis			Multivariate analysis
	Odds ratio	95% CI	p-value	Odds ratio	95% CI	p-value
Male gender	0.09	0.01–0.805	0.008	0.08	0.007–0.834	0.035
Post-BD FEV1 ≥50% predicted	0.21	0.07–0.61	0.003	0.11	0.025–0.443	0.002
CAT score ≥10	2.90	0.98–8.59	0.005	1.43	0.347–5.952	0.615
mMRC scale ≥2	2.33	1.37–3.94	0.0006	3.36	0.89–12.65	0.07
Bronchiectasis	2.76	1.04–7.29	0.037	4.99	1.31–18.94	0.018

Notes: The dependent variable is the frequent COPD exacerbation (≥2 in the past year) and/or hospitalization due to exacerbation in the past year in 72 patients (binary variables). Each independent variable was adjusted for gender, severity of airflow obstruction (post-BD FEV₁ ≥50% predicted), severity of COPD symptoms (CAT ≥10), severity of dyspnea symptoms (mMRC ≥2) and bronchiectasis. The statistical significance was determined by p-value <0.05.

Abbreviations: BD, bronchodilator; CAT, COPD assessment test; FEV₁, forced expiratory volume in 1 second; mMRC, modified Medical Research Council Dyspnea Scale.

Table 3 Symptoms and physiological conditions of COPD patients with and without bronchiectasis

Parameters	Patients without CT-detected bronchiectasis (N=38)	Patients with CT-detected bronchiectasis (N=34)	p-value
Age (years)a	75.0 (69.0–79.5)	71.0 (63.0–78.0)	0.14
Post-bronchodilator FEV1% predicteda	59.50 (44.50–77.0)	60.0 (46.0–75.25)	0.91
CAT scorea	13.0 (3–37)	13.0 (2–32)	0.49
mMRC scalea	1.0 (0–4)	1.0 (0–4)	0.22
COPD exacerbations ≥2 years or hospitalizations ≥1 year n (%)	11 (37.93%)	18 (62.07%)	0.038

Notes:

a Median and IQR. Data are presented as median, IQR and proportion (%). The statistical significance was determined by p-value <0.05.

Abbreviations: CAT, COPD assessment test; FEV₁, forced expiratory volume in 1 second; CT, computed tomography; IQR, interquartile range; mMRC, modified Medical Research Council Dyspnea Scale.

Table 4 Proportion of bacterial and mycobacterial pathogens isolated from the sputum of COPD patients, including isolated pathogens in patients with and without frequent or severe exacerbation

Parameter	Total (n=72)	COPD with non-frequent exacerbation (N=43)	COPD with frequent exacerbation (n=29)	p-value
Bronchiectasis, n (%)	34 (47.2)	16 (37.2%)	18 (62.1%)	0.038
Bacterial colonization, n (%)	9 (12.5)	4 (9.3%)	5 (17.24%)	0.47
Pseudomonas aeruginosa, n (%)	3 (4.16)	2 (4.56)	1 (3.45)
Acinetobacter baumannii, n (%)	3 (4.16)	0	3 (10.34)
Klebsiella pneumoniae, n (%)	2 (2.78)	1 (2.32)	1 (3.45)
Streptococcus viridans, n (%)	1 (1.38)	0	1 (3.45)
Mycobacterial growth, n (%)	8 (11.11)	6 (13.95)	2 (6.9)	0.35

Notes: Data are presented as proportion (%). The statistical significance was determined by p-value <0.05.

Table 5 Other CT findings among COPD patients

CT findings	Frequency, n (%)
Parenchymal lung abnormalities (decreased lung attenuation)
Pulmonary emphysema	59 (81.9)
Centrilobular emphysema	52 (88.13)
Paraseptal emphysema	34 (57.62)
Panlobular emphysema	14 (23.72)
Parenchymal lung abnormalities (increased lung attenuation)
Solid and ground-glass pulmonary nodules	62 (86.11)
Small airway abnormalities
Tree-in-bud appearance (centrilobular nodules and bronchiolectasis)	10 (13.89)
Air trapping	48 (66.67)
Large airway abnormalities
Tracheobronchomalacia	10 (13.89)
Extra-pulmonary and vascular abnormalities
Lymph node enlargement	14 (19.4)
Calcified aorta	67 (93.05)
Coronary artery calcification	60 (83.33)
Pulmonary hypertension	13 (18.05)

Abbreviation: CT, computed tomography.

Figure 1 Axial CT image with a lung-window setting showing diffuse emphysema with varicose bronchiectasis in the right lower lobe and tubular bronchiectasis in the left lower lobe.

Abbreviation: CT, computed tomography.

Figure 2 Axial CT images with a lung-window setting showing tubular bronchiectasis with the signet ring sign in the right lower lobe (A–C) and the tram-track sign in the left lower lobe (B).

Abbreviation: CT, computed tomography.

Figure 3 Axial CT images with a lung-window setting showing combined tubular and varicose bronchiectasis, emphysema and fibrosis in bilateral upper lobes (A), right middle lobe (B) and right lower lobe (B).

Abbreviation: CT, computed tomography.

Figure 4 Axial CT images with a lung-window setting showing severe centrilobular emphysema and bronchiectasis in both lungs (A–C).

Abbreviation: CT, computed tomography.

Figure 5 Axial CT image with a lung-window setting showing emphysema and bronchial wall thickening in bilateral lower lobes.

Abbreviation: CT, computed tomography.

Figure 6 Axial CT images with a mediastinal-window setting showing a dilated main pulmonary artery (A) and calcifications of the aorta and coronary arteries (B–C).

Abbreviation: CT, computed tomography.