Role of tuberculosis in COPD

Background: Recent studies emphasize that past tuberculosis (TB) infection is an important risk factor for development of COPD. In this study, we analyzed the patients hospitalized due to COPD exacerbation according to having or not TB scars. Material and Methods: Hospitalized COPD patients were included consecutively (n=155). After obtaining detailed demographical and clinical characteristics, the patients were divided into 2 groups as 1)with and 2)without old TB scars. Groups were compared regarding the multiple characteristics and, were followed-up for 6 months for mortality. Results: 23 patients had old TB scars on chest films (14.8%). Mean age of patients with and without TB scars were 63.8±12.1 and 70.9±10.4 years respectively (p=0.01). There were no differences between groups regarding sex distribution, pulmonary functions, arterial blood gases, hematological and biochemical parameters, exacerbation rates during the last 12 months, comorbidities, and length of hospital stay, needs for invasive and non-invasive mechanical ventilation, and admission to the ICU. Any significant difference between mortality rates after discharge was not detected. However, it was found that first COPD diagnosis had been made 8 years earlier in COPD patients with old TB scars (53.3 ± 14.1 years versus 61.1 ± 12.0 years; p = 0.006). Conclusion: Mean age of symptoms onset was found significantly earlier in COPD patients with old TB scars. Although the patients with TB scars were significantly younger, their mortality rates were comparable to the patients without TB scars. Past TB infection leaving scars were found as an important risk factor for earlier development and faster progression of COPD in our study.