Burden of Bronchiectasis Among COPD Patients in Bangladesh: Insights from a Cross-Sectional Study

BackgroundBronchiectasis is an increasingly recognized structural complication among patients with chronic obstructive pulmonary disease (COPD), yet evidence from Bangladesh remains limited. This study aimed to determine the prevalence, clinical characteristics, radiological patterns, and associated factors of bronchiectasis among COPD patients in tertiary-level hospitals. MethodsA cross-sectional study was conducted among 129 COPD patients regardless of age distribution, all are met GOLD criteria and underwent high-resolution computed tomography (HRCT). Data on sociodemographic, behavioral, clinical, radiological, laboratory, and quality-of-life characteristics were analyzed using descriptive statistics, chi-square tests, t-tests, correlation analyses, and binary logistic regression. ResultsBronchiectasis was detected in 73.6% of COPD patients, with cylindrical bronchiectasis being the most common subtype (48.4%). Patients with bronchiectasis had a significantly longer duration of COPD (7.58 {+/-} 3.36 years vs. 2.51 {+/-} 1.67 years; p < 0.001) and more frequent symptoms, including chronic cough (72.1%), purulent sputum (34.9%), and higher dyspnea grades. Mucus plugging showed a perfect association with bronchiectasis (p = 0.001). Significant predictors of bronchiectasis included rural residence (AOR 5.82; 95% CI 1.34-25.29) and smoking habit (AOR 3.69; 95% CI 1.01-13.49). A weak but significant negative correlation was found between serum albumin and CRP (r = -0.211; p = 0.016), indicating systemic inflammation, while smoking duration was negatively correlated with FEV{square} (r = -0.174; p = 0.048). Quality of life was markedly impaired, with over 70% reporting poor or fair status. ConclusionBronchiectasis is highly prevalent among COPD patients in Bangladesh and is associated with longer disease duration, greater symptom burden, functional impairment, structural lung abnormalities, and poor quality of life. Rural residence, smoking, and mucus plugging emerged as key determinants. Early HRCT-based screening, phenotype-specific management, reduction of biomass and tobacco exposure, and improved rural respiratory care are essential to mitigate disease progression and improve outcomes.