Chronic bronchitis is a common health complication among patients with chronic obstructive disease (COPD) and it may highlight a subtype of the disease that places patients at risk for increased severity and exacerbations, say researchers.
Jean Corhay (CHU Sart-Tilman, Liège, Belgium) and colleagues studied 974 patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 2–4 disease and found that 64 percent had chronic bronchitis. These affected patients had significantly more chronic respiratory failure, cachexia, and skeletal muscle wasting than other patients, and a greater number of pack–years smoking, poorer spirometry results, and were more likely to have emphysema.
Corhay and colleagues, writing in the International Journal of Clinical Practice, say that their results help clarify the prevalence of chronic bronchitis among COPD patients, as well as suggest that it “could represent a subtype of COPD that is easy to identify in clinical practice and appears to be associated with increased disease severity and with a high risk of exacerbations.”
However, Pierre-Regis Burgel (Paris Descartes University, France) writing in an accompanying editorial disagrees.
“[A]ssessment of individual risk cannot rely on this single disease attribute,” he comments, noting that in a previous study the risk for COPD-related death was moderately increased in those with chronic bronchitis and mild airflow limitation but markedly increased in those with chronic bronchitis and severe airflow limitation.
“In conclusion, cough and sputum production may be markers of an active disease process in COPD patients, and may be used, in association with other [patient] characteristics, to identify patients at high risk of outcomes (e.g., exacerbations, death).”