Influence of bronchiectasis in patients hospitalized due to acute exacerbation of COPD

Objective: To analyze the impact of bronchiectasis in patients hospitalized due to acute exacerbation of COPD (AE-COPD) between 2006 and 2014 in Spain. Methods: An observational retrospective study. AE-COPD were identified using the basic minimal set of information from both public and private health system in Spain. Patients with the main diagnosis of AE-COPD were selected and divided in 2 groups, according to the existence or not of bronchiectasis as a secondary diagnosis. Results: 386,646 patients hospitalized for AE-COPD were identified. Of these, 5.09% had bronchiectasis. Computerized axial tomography scan (CAT) and fiberoptic bronchoscopy were performed more frequently in patients with COPD and bronchiectasis than in those without them (14.0% vs 6.81% and 1.73% vs 0.97% respectively, p <0.05 in both cases). Pseudomonas aeruginosa was more frequently found in the first group of patients (11.74% vs. 2.51%, p <0.05). Mean hospital stay in patients with COPD and bronchiectasis was significantly higher (9.57 vs 8.27 days, p <0.05), as well as cost and likely to be readmitted to hospital (3971.67 € vs 3664.75 € and 22.38% vs 10.23% respectively, p <0.05 in both cases). After adjusting possible confounders, bronchiectasis were not related to higher mortality in patients hospitalized due to AE- COPD (OR 0.94, 95% CI 0.88-1.01). Conclusion: The presence of bronchiectasis in patients admitted for an AE-COPD is associated with a greater probability of performing invasive procedures and finding Pseudomonas aeruginosa, as well as a longer hospital stay and cost and a higher probability of rehospitalization.