Smoking, pulmonary hypertension, and a decline in lung function are associated with an increased risk of death in people with chronic obstructive pulmonary disease (COPD). Now researchers in Spain have added another potential risk factor: the presence and severity of bronchiectasis. Compared with unaffected patients with COPD, patients with bronchiectasis had more than double the risk of dying than those without, according to a prospective, observational study published online February 8 in the American Journal of Respiratory and Critical Care Medicine . Miguel Angel Martínez-García, MD, from the Pneumology Service at the University and Polytechnic La Fe Hospital in Valencia, Spain, and colleagues assessed 201 participants with moderate to severe COPD from a consecutive series of outpatients diagnosed at 1 of 2 specialty clinics in Spain. The mean age of participants was 70 years, and 91% were men. A majority (77%) featured radiologic signs of emphysema. Patients were diagn...