Suspected bronchiectasis tied to higher risk of mortality in smokers: Study

USA: A recent study published in the Annals of Internal Medicine has revealed an association between suspected bronchiectasis and a heightened risk for mortality in patients with normal and obstructive spirometry.

Bronchiectasis is a condition defined by widened lung airways, cough and sputum production, and frequent infections, often present along with chronic obstructive pulmonary disease (COPD).

This overlap is associated with airflow obstruction and higher mortality in adults. As healthcare systems now provide access to lung image data more commonly than before, bronchiectasis can be detected incidentally on radiological scans of patients with mild or no symptoms.

A team led by researchers at Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system, studied the association between suspected bronchiectasis and mortality in adults with a history of smoking. The researchers analyzed a dataset with information collected over 11 years from more than 7,500 patients, including those with normal breathing test results and others with significantly impaired airflow. Using a combination of clinical and imaging data, participants were categorized into suspected bronchiectasis or non-suspected bronchiectasis groups.

The study found that suspected bronchiectasis in participants with normal and obstructed airflow was associated with a higher risk of mortality. This increased risk, the investigators suggest, could be explained by the frequent inflammation and exposure to pathogens caused by smoking. Since obstructed airflow is a characteristic of COPD, the study also furthered understanding of the association between mortality risk and disease severity.

“Our study represents one of the largest evaluations of suspected bronchiectasis in understudied groups of adults with a history of smoking,” said corresponding author Alejandro Diaz, MD, MPH, of the Division of Pulmonary and Critical Care Medicine. “These findings suggest that using lung imaging as a clinical tool to identify bronchiectasis could help improve patient care.”

References:- Alejandro A. Diaz, MD, MPH, Wei Wang, PhD, Jose L. Orejas, MD, Rim Elalami, BS, Wojciech R. Dolliver, MD, Pietro Nardelli, PhD, Ruben San José Estépar, MS, Bina Choi, MD, Carrie L. Pistenmaa, MD, MPH, James C. Ross, PhD, Diego J. Maselli, MD, Andrew Yen, MD, Kendra A. Young, PhD, Gregory L. Kinney, PhD, Michael H. Cho, MD, MPH, and Raul San José Estépar, PhD View fewer authors Author, Article, and Disclosure Information https://doi.org/10.7326/M23-1125