Suspected bronchiectasis linked to elevated mortality risk in adults with normal and obstructive spirometry

A recent study conducted as part of the COPDGene (Genetic Epidemiology of Chronic Obstructive Pulmonary Disease) project unveiled a concerning association between suspected bronchiectasis and mortality among adults with a history of smoking. The findings were published in the Annals of Internal Medicine.

This research, involving 7,662 non-Hispanic Black and White adults aged 45 to 80 spanned a median follow-up period of 11 years and focused on individuals with various spirometry profiles: normal, preserved ratio impaired spirometry (PRISm), and obstructive spirometry. Suspected bronchiectasis was identified through an innovative approach that involved computed tomography (CT) scans and clinical symptoms, such as cough, phlegm, dyspnea, and a history of exacerbations.

The findings revealed that, approximately 17.6% had suspected bronchiectasis. What's more alarming is that individuals with suspected bronchiectasis faced a significantly higher risk of mortality compared to their counterparts without this condition. The 10-year mortality risk was notably elevated in those with suspected bronchiectasis, with the most substantial difference observed in individuals with normal spirometry, followed by PRISm and obstructive spirometry.

This research is vital as it extends our understanding of the potential consequences of smoking-related health issues beyond the well-documented chronic obstructive pulmonary disease (COPD). Bronchiectasis, a condition characterized by damaged airways, seems to be associated with higher mortality rates in individuals who have smoked.

The study's limitations include the focus on only two racial groups and the reliance on a single measurement to define bronchiectasis on CT scans. Additionally, the symptoms associated with suspected bronchiectasis were found to be nonspecific.

The results of this study underscore the importance of early detection and management of bronchiectasis in adults with a history of smoking. Identifying and addressing this condition may play a critical role in reducing mortality rates among this vulnerable population.

Reference:

Diaz, A. A., Wang, W., Orejas, J. L., Elalami, R., Dolliver, W. R., Nardelli, P., San José Estépar, R., Young, K. A., Kinney, G. L., Cho, M. H., & San José Estépar, R. (2023). Suspected Bronchiectasis and Mortality in Adults With a History of Smoking Who Have Normal and Impaired Lung Function. In Annals of Internal Medicine. American College of Physicians. https://doi.org/10.7326/m23-1125