Does coexistence with bronchiectasis influence intensive care unit outcome in patients with chronic obstructive pulmonary disease?

Heart Lung. Jan-Feb 2006;35(1):58-65. doi: 10.1016/j.hrtlng.2005.04.003.

Abstract

Background: Bronchiectasis is associated with chronic obstructive pulmonary disease (COPD) in 30% to 50% of patients. This study evaluated whether association with bronchiectasis has any influence on morbidity and mortality in patients with COPD during their intensive care unit (ICU) stay.

Methods: The study was conducted at a respiratory ICU of a university hospital, and 93 mechanically ventilated patients with COPD were studied. Twenty-nine (31%) of 93 patients with COPD also had bronchiectasis. Patients with bronchiectasis had more frequent hospitalizations, more severe airflow limitation, and higher pulmonary artery pressure than patients without bronchiectasis. Duration of ICU (27+/-32 days [median: 14]; 16+/-16 days [median: 9]; P=.01) and hospital stays (44+/-44 days [median: 24.5]; 28+/-26 days (median: 20); P=.046) in patients with bronchiectasis were significantly longer than in patients without bronchiectasis, respectively. Bronchiectasis was an independent predictor for ICU stay longer than 10 days (odds ratio: 5, 95% confidence interval: 1.02-21, P=.043). The development rate of ventilator-associated pneumonia, especially with Pseudomonas aeruginosa, was significantly higher in patients with bronchiectasis (P=.034). Despite these prolonged durations, bronchiectasis did not increase mortality in this study population (P=.865).

Results: These results suggest that the coexistence of bronchiectasis in patients with COPD may increase the duration of ICU stay and hospitalization but does not influence the mortality.

MeSH terms

  • APACHE
  • Aged
  • Bronchiectasis / complications*
  • Bronchiectasis / mortality
  • Bronchiectasis / therapy
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Hypertension / etiology
  • Intensive Care Units
  • Length of Stay
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Pulmonary Disease, Chronic Obstructive / etiology
  • Pulmonary Disease, Chronic Obstructive / mortality
  • Pulmonary Disease, Chronic Obstructive / therapy
  • Respiration, Artificial
  • Turkey / epidemiology
  • Ventilator Weaning