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March 26, 2026Open Access

A Prospective Observational Study Evaluating the PRogression Of BronchiEctasis in COPD Patients - Results from the PROBE - COPD Study

RVRajesh VenkitakrishnanRajagiri Hospital ASAthulya Sudheendranath AVAnand VijayRajagiri Hospital

Key Points

This study aims to evaluate the progression of bronchiectasis in stage E COPD patients over one year and identify contributing risk factors.
Patients with stage E COPD underwent high-resolution CT (HRCT) for bronchiectasis classification.
Participants were followed for 12 months with quarterly clinical evaluations and repeat HRCT.
Sputum culture and spirometry were performed at six months and one year, respectively.
Univariate analysis was used to explore predictors of progression.
33 out of 104 patients had bronchiectasis at baseline, with 22 (66.67%) showing progression after one year.
New bronchiectasis developed in 37 out of 71 patients who initially did not have it (52.1%).
Patients with bronchiectasis experienced more frequent exacerbations (84.8% vs. 75.8%) and higher hospitalisation rates (60.6% vs. 35.2%).

Abstract

Background: Bronchiectasis is increasingly recognised in individuals suffering from chronic obstructive pulmonary disease (COPD) and is associated with adverse outcomes. However, data on its temporal course and risk factors for progression in advanced COPD remain limited. Objective: The study aimed to assess the progression of bronchiectasis in stage E COPD patients over one-year, identify factors contributing to its advancement, and compare clinical outcomes between patients diagnosed with bronchiectasis and those without the condition. Methods: Patients with stage E COPD underwent high-resolution CT (HRCT) and were classified according to whether bronchiectasis present or absent at baseline. All participants were followed for 12 months, with quarterly clinical evaluation, six-monthly sputum culture, spirometry, and repeat HRCT at one-year. Progression of bronchiectasis, decline in lung function, exacerbations, hospitalisations, and mortality were assessed. Predictors of progression were explored using univariate analysis. Results: Of the 104 patients, 33 (31.7%) had bronchiectasis at baseline. At one-year, 22 of these (66.67%) showed radiological progression and 8 (24.2%) remained stable Among the 71 without bronchiectasis, new bronchiectasis developed in 37 (52.1%). Frequent exacerbations (≥ 2/year) occurred more often in patients with bronchiectasis compared to those without (84.8% vs. 75.8%, P=0.023). Hospitalisation rates were also higher in the bronchiectasis group (60.6% vs. 35.2%, P< 0.001). Conclusion: Bronchiectasis was present in one-third of stage E COPD patients at baseline, and more than half of those without bronchiectasis developed new lesions during follow-up. COPD patients with bronchiectasis had higher exacerbation frequency, hospitalisations, and greater progression of disease, underscoring its role as a poor prognostic marker in advanced COPD. Plain Language Summary: Bronchiectasis is common in advanced COPD and often progresses rapidly. In the PROBE-COPD study, patients with bronchiectasis had more exacerbations, hospitalizations, and worse outcomes, underscoring its role as a poor prognostic marker. Progression of bronchiectasis over time occurs in severe COPD patients. Presence of bronchiectasis may be looked upon as a prognostic phenotype. Keywords: COPD, bronchiectasis, exacerbations

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