Evaluation of the Effect of Comorbid Bronchiectasis on Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

Cansu Yılmaz; Murat Acat; Serkan Öner; Habibe İnci; Didem Adahan

doi:10.18521/ktd.997761

Research Article

Kronik Obstrüktif Akciğer Hastalığı Olan Hastalarda Komorbid Bronşektazinin Yaşam Kalitesine Etkisinin Değerlendirilmesi

Year 2022, Volume: 14 Issue: 2, 357 - 365, 29.06.2022

Cansu Yılmaz Murat Acat Serkan Öner Habibe İnci Didem Adahan

https://doi.org/10.18521/ktd.997761

Abstract

Amaç: Bu çalışmanın amacı Kronik Obstrüktif Akciğer Hastalığı (KOAH) olan hastalarda eşlik eden bronşektazinin yaşam kalitesine etkisini değerlendirmektir.
Metod: Çalışmamıza KOAH tanısı konan 103 hasta dahil edildi. Spirometrik ölçümler yapıldı. Veri toplamak için, 6 Dakika Yürüme Testi (6MWT), Modifiye Tıbbi Araştırma Konseyi (mMRC) dispne ölçeği, KOAH Değerlendirme Testi (CAT), St. George Solunum Anketi (SGRQ) ve Kısa Form 36 (SF-36) yaşam kalitesi anketini içeren ölçüm araçları kullanıldı. Ayrıca tüm hastaların son üç yıla ait yüksek Çözünürlüklü Bilgisayarlı Tomografi (HRCT) görüntüleri çalışmaya dahil edildi.
Bulgular: Hastaların %93,2'si erkek olup, yaş ortalaması 64,79±9,35 yıldı. Tüm hastalarda SGRQ ve SF-36 yaşam kalitesi puanlarının normal olanlara göre yarı yarıya düştüğü bulundu. Zorlu ekspirasyonun ilk saniyesindeki volüm/zorlu vital kapasite (FEV1/FVC) değerleri bronşektazili grupta anlamlı olarak daha düşüktü. Hastaların mMRC dispne skalası ile CAT skorları, 6DYT mesafeleri ve SGRQ ve SF-36'nın tüm alt ölçekleri arasında anlamlı bir ilişki bulundu. Ayrıca FEV1 değerleri ile SGRQ'nun tüm alt ölçekleri ve SF-36'nın alt ölçekleri arasında da anlamlı bir ilişki bulundu.
Sonuç: Çalışmamızda KOAH'lı ve bronşektazili hastaların yaşam kalitesi puanlarını tek başına KOAH'lı hastalarla karşılaştırdığımızda her iki grubun yaşam kalitesinin bozulduğunu ancak aralarında anlamlı bir fark olmadığını bulduk.

Keywords

Bronşektazi, Kronik Obstrüktif Akciğer Hastalığı, Yaşam Kalitesi

Supporting Institution

yok

Project Number

yok

Thanks

yok

References

1. Singh D, Agusti A, Anzueto A, Barnes PJ, Bourbeau J, Celli BR, et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: the GOLD science committee report 2019. Eur Respir J. 2019 May 18;53(5):1900164.
2. Barker AF. Bronchiectasis. N Engl J Med. 2002 May 2;346(18):1383-93.
3. King PT. The pathophysiology of bronchiectasis. Int J Chron Obstruct Pulmon Dis. 2009;4:411-9.
4. Tülek, B. Co-occurrence of Chronic Obstructive Pulmonary Disease and Bronchiectasis: Is It a New Phenotype of Chronic Obstructive Pulmonary Disease 2014. Eurasian J Pulmonol, 16, 8-12.
5. Martínez-García MÁ, Soler-Cataluña JJ, Donat Sanz Y, Catalán Serra P, Agramunt Lerma M, Ballestín Vicente J, et al. Factors associated with bronchiectasis in patients with COPD. Chest. 2011 Nov;140(5):1130-1137.
6. Tulek B, Kivrak AS, Ozbek S, Kanat F and Suerdem M. Phenotyping of chronic obstructive pulmonary disease using the modified Bhalla scoring system for high-resolution computed tomography. Can Respir J. 2013 Mar-Apr;20(2):91-6. PMID: 23616965; PMCID: PMC3630042.
7. Yenilmez Ö, Gürsoy S, Evyapan F and Kitiş A. KOAH’li bireylerde aktivite katilimi ve yaşam kalitesinin incelenmesi 2018. Yaşlı Sorunları Araştırma Dergisi, 11(2), 30-36.
8. Miller MR. ATS/ERS Task Force. Standardisation of spirometry. Eur Respir J. 2005 Aug;26(2):319-38.
9. Viegi G, Pistelli F, Sherrill DL, Maio S, Baldacci S and Carrozzi L. Definition, epidemiology and natural history of COPD. Eur Respir J. 2007 Nov;30(5):993-1013.
10. Jones PW, Harding G, Berry P, Wiklund, I., Chen, W. H., and Leidy, N. K. Development and first validation of the COPD Assessment Test. Eur Respir J. 2009 Sep;34(3):648-54. PMID: 19720809.
11. Yorgancıoğlu A, Polatlı M, Aydemir Ö, Kırkıl, G, Köktürk, N, Uysal, A, et al. KOAH değerlendirme testinin Türkçe geçerlilik ve güvenilirliği [Reliability and validity of Turkish version of COPD assessment test]. Tuberk Toraks. 2012;60(4):314-20. Turkish. PMID: 23289460.
12. Jones PW, Quirk FH, Baveystock CM and Littlejohns, P. A self-complete measure of health status for chronic airflow limitation. The St. George's Respiratory Questionnaire. Am Rev Respir Dis. 1992 Jun;145(6):1321-7. PMID: 1595997.
13. Polatlı M, Yorgancıoğlu A, Aydemir Ö, Yılmaz Demirci N, Kırkıl G, Atış Naycı S, et al. St. George solunum anketinin Türkçe geçerlilik ve güvenilirliği [Validity and reliability of Turkish version of St. George's respiratory questionnaire]. Tuberk Toraks. 2013;61(2):81-7.
14. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992 Jun;30(6):473-83. PMID: 1593914.
15. Kocyigit, H. Kisa Form-36 (KF-36)'nm Turkce versiyonunun guvenilirligi ve gecerliligi 1999. Ilaç ve tedavi dergisi, 12, 102-106.
16. da Silva SM, Paschoal IA, De Capitani EM, Moreira, M. M., Palhares, L. C. and Pereira, M. C. COPD phenotypes on computed tomography and its correlation with selected lung function variables in severe patients. Int J Chron Obstruct Pulmon Dis. 2016 Mar 16;11:503-13.
17. Kocabaş, A. Kronik obstrüktif akciğer hastaliği epidemiyolojisi ve risk faktörleri 2010. TTD Toraks Cerrahisi Bülteni, 1(2), 105-113.
18. Wilson CB, Jones PW, O'Leary CJ, Cole, P. J. and Wilson, R. Validation of the St. George's Respiratory Questionnaire in bronchiectasis. Am J Respir Crit Care Med. 1997 Aug;156(2 Pt 1):536-41. PMID: 9279236.
19. Patel IS, Vlahos I, Wilkinson TM, Lloyd-Owen SJ, Donaldson GC, Wilks M, et al. Bronchiectasis, exacerbation indices, and inflammation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2004 Aug 15;170(4):400-7. Epub 2004 May 6. PMID: 15130905.
20. O'Brien C, Guest PJ, Hill SL and Stockley RA. Physiological and radiological characterisation of patients diagnosed with chronic obstructive pulmonary disease in primary care. Thorax. 2000 Aug;55(8):635-42. PMID: 10899238; PMCID: PMC1745831.
21. O Kurtulgan, M Ahmet, U Meral. Kronik obstrüktif akciğer hastalığında ekspiratuar yüksek rezolüsyonlu bilgisayarlı tomografi bulguları ile trakeal indeks ve solunum fonksiyon testleri arasındaki ilişki 2012. Dicle Tıp Dergisi, 39(1), 42-48.
22. Halpin DMG, Criner GJ, Papi A, Singh D, Anzueto A, Martivez FJ, et al. Global Initiative for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease. The 2020 GOLD Science Committee Report on COVID-19 and Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2021 Jan 1;203(1):24-36. PMID: 33146552; PMCID: PMC7781116.
23. Kuyucu T, Güçlü SZ, Saylan B, Demir C, Senol T, Güner S, et al; Turkey SUNRISE Study Group. A cross-sectional observational study to investigate daily symptom variability, effects of symptom on morning activities and therapeutic expectations of patients and physicians in COPD-SUNRISE study. Tuberk Toraks. 2011;59(4):328-39. PMID: 22233302.
24. Donaldson GC, Seemungal TA, Bhowmik A and Wedzicha JA. Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax. 2002 Oct;57(10):847-52. doi: 10.1136/thorax.57.10.847. Erratum in: Thorax. 2008 Aug;63(8):753. PMID: 12324669; PMCID: PMC1746193.
25. Gudmundsson G, Gislason T, Janson C, Lindberg E, Hallin R, Ulrik CS, et al. Risk factors for rehospitalisation in COPD: role of health status, anxiety and depression. Eur Respir J. 2005 Sep;26(3):414-9. PMID: 16135721.
26. Atasever A, Erdinç E. KOAH’da yaşam kalitesinin değerlendirilmesi 2003. Tüberküloz ve Toraks Dergisi, 51(4), 446-55.
27. Akbay S, Kurt B, Ertürk A, Gülhan M and Çapan N. Kronik obstrüktif akciğer hastalığında yaşam kalitesi ve solunum fonksiyon testi ile ilişkisi 2001. Tüberküloz ve Toraks Dergisi, 49(3), 338-44.
28. Kütükcü EÇ, Arıkan H, Sağlam M, Yağlı NV, Deniz İNAL, Öksüz Ç, et al. Kronik obstrüktif akciğer hastalarında çok boyutlu hastalık şiddeti ve günlük yaşam aktiviteleri arasındaki ilişkinin incelenmesi 2015. Journal of Exercise Therapy and Rehabilitation, 2(2), 53-60.
29. Sevgili S, Hasanoğlu H C, Karalezli A and Er M. Bronchial reversibility in the patients with bronchiectasis 2009. Tuberkuloz ve toraks, 57(1), 38-47.
30. Demir G, Akkoca O, Doğan R, Saryal S and Karabıyıkoğlu G. KOAH'da dispne ve yaşam kalitesinin değerlendirilmesi [The evaluation of dyspnea and quality of life in COPD]. Tuberk Toraks. 2003;51(4):365-72. Turkish. PMID: 15143383.
31. Başyiğit İ. KOAH tanımı ve klinik özellikleri 2010. TTD Toraks Cerrahisi Bülteni, 1(2), 102-104.
32. Miyazaki M, Nakamura H, Chubachi S, Sasaki M, Haraguchi M, Yoshida S, et al; Keio COPD Comorbidity Research (K-CCR) Group. Analysis of comorbid factors that increase the COPD assessment test scores. Respir Res. 2014 Feb 6;15(1):13. PMID: 24502760; PMCID: PMC3922022.
33. Cömert SŞ, Müzeyyen, ERK, Müsellim B and Küçükusta AR. Kronik Obstrüktif Akciğer Hastaliğinda Yaşam Kalitesini Etkileyen Fonksiyonel Ve Antropometrik Parametreler. İzmir Göğüs Hastanesi Dergisi, 25(2), 89-100.
34. Lee AL, Button BM, Ellis S, Stirling R, Wilson JW, Holland AE, et al. Clinical determinants of the 6-Minute Walk Test in bronchiectasis. Respir Med. 2009 May;103(5):780-5. doi: 10.1016/j.rmed.2008.11.005. Epub 2008 Dec 12. PMID: 19070473.

Evaluation of the Effect of Comorbid Bronchiectasis on Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

Year 2022, Volume: 14 Issue: 2, 357 - 365, 29.06.2022

Cansu Yılmaz Murat Acat Serkan Öner Habibe İnci Didem Adahan

https://doi.org/10.18521/ktd.997761

Abstract

Objective: The objective of this study was to evaluate the effect of comorbid bronchiectasis on quality-of-life in patients with Chronic Obstructive Pulmonary Disease (COPD).
Method: 103 patients were diagnosed with COPD were included in our study. Spirometric measurements were made. The following measurement tools were used to collect data: 6-Minute Walk Test (6MWT), Modified Medical Research Council (mMRC) dyspnea scale, COPD Assessment Test (CAT), St. George Respiratory Questionnaire (SGRQ), and Short Form 36 (SF-36) quality-of-life questionnaire. Furthermore, all the patients’ high Resolution Computed Tomography (HRCT) images for the last three years were included in the study.
Result: 93.2% of the patients were male, with a mean age of 64.79±9.35 years. It was found that SGRQ and SF-36 quality-of-life scores decreased by half in all the patients compared to normal ones. The volume/forced vital capacity (FEV1/FVC) values in the first second of forced expiration were significantly lower in the group with bronchiectasis. A significant correlation was found to exist between the patients’ mMRC dyspnea scale and CAT scores, 6MWT distances, and all subscales of SGRQ and SF-36. In addition, a significant correlation was also found to exist between FEV1 values and all subscales of SGRQ, and between subscales of SF-36.
Conclusion: In our study, when we compared the quality-of-life scores of the patients with COPD and bronchiectasis with those with COPD alone, we found that the quality-of-life of both groups was impaired, but there was no significant difference between them.

Keywords

Bronchiectasis, Chronic Obstructive Pulmonary Disease, Quality of Life

Project Number

yok

References

1. Singh D, Agusti A, Anzueto A, Barnes PJ, Bourbeau J, Celli BR, et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: the GOLD science committee report 2019. Eur Respir J. 2019 May 18;53(5):1900164.
2. Barker AF. Bronchiectasis. N Engl J Med. 2002 May 2;346(18):1383-93.
3. King PT. The pathophysiology of bronchiectasis. Int J Chron Obstruct Pulmon Dis. 2009;4:411-9.
4. Tülek, B. Co-occurrence of Chronic Obstructive Pulmonary Disease and Bronchiectasis: Is It a New Phenotype of Chronic Obstructive Pulmonary Disease 2014. Eurasian J Pulmonol, 16, 8-12.
5. Martínez-García MÁ, Soler-Cataluña JJ, Donat Sanz Y, Catalán Serra P, Agramunt Lerma M, Ballestín Vicente J, et al. Factors associated with bronchiectasis in patients with COPD. Chest. 2011 Nov;140(5):1130-1137.
6. Tulek B, Kivrak AS, Ozbek S, Kanat F and Suerdem M. Phenotyping of chronic obstructive pulmonary disease using the modified Bhalla scoring system for high-resolution computed tomography. Can Respir J. 2013 Mar-Apr;20(2):91-6. PMID: 23616965; PMCID: PMC3630042.
7. Yenilmez Ö, Gürsoy S, Evyapan F and Kitiş A. KOAH’li bireylerde aktivite katilimi ve yaşam kalitesinin incelenmesi 2018. Yaşlı Sorunları Araştırma Dergisi, 11(2), 30-36.
8. Miller MR. ATS/ERS Task Force. Standardisation of spirometry. Eur Respir J. 2005 Aug;26(2):319-38.
9. Viegi G, Pistelli F, Sherrill DL, Maio S, Baldacci S and Carrozzi L. Definition, epidemiology and natural history of COPD. Eur Respir J. 2007 Nov;30(5):993-1013.
10. Jones PW, Harding G, Berry P, Wiklund, I., Chen, W. H., and Leidy, N. K. Development and first validation of the COPD Assessment Test. Eur Respir J. 2009 Sep;34(3):648-54. PMID: 19720809.
11. Yorgancıoğlu A, Polatlı M, Aydemir Ö, Kırkıl, G, Köktürk, N, Uysal, A, et al. KOAH değerlendirme testinin Türkçe geçerlilik ve güvenilirliği [Reliability and validity of Turkish version of COPD assessment test]. Tuberk Toraks. 2012;60(4):314-20. Turkish. PMID: 23289460.
12. Jones PW, Quirk FH, Baveystock CM and Littlejohns, P. A self-complete measure of health status for chronic airflow limitation. The St. George's Respiratory Questionnaire. Am Rev Respir Dis. 1992 Jun;145(6):1321-7. PMID: 1595997.
13. Polatlı M, Yorgancıoğlu A, Aydemir Ö, Yılmaz Demirci N, Kırkıl G, Atış Naycı S, et al. St. George solunum anketinin Türkçe geçerlilik ve güvenilirliği [Validity and reliability of Turkish version of St. George's respiratory questionnaire]. Tuberk Toraks. 2013;61(2):81-7.
14. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992 Jun;30(6):473-83. PMID: 1593914.
15. Kocyigit, H. Kisa Form-36 (KF-36)'nm Turkce versiyonunun guvenilirligi ve gecerliligi 1999. Ilaç ve tedavi dergisi, 12, 102-106.
16. da Silva SM, Paschoal IA, De Capitani EM, Moreira, M. M., Palhares, L. C. and Pereira, M. C. COPD phenotypes on computed tomography and its correlation with selected lung function variables in severe patients. Int J Chron Obstruct Pulmon Dis. 2016 Mar 16;11:503-13.
17. Kocabaş, A. Kronik obstrüktif akciğer hastaliği epidemiyolojisi ve risk faktörleri 2010. TTD Toraks Cerrahisi Bülteni, 1(2), 105-113.
18. Wilson CB, Jones PW, O'Leary CJ, Cole, P. J. and Wilson, R. Validation of the St. George's Respiratory Questionnaire in bronchiectasis. Am J Respir Crit Care Med. 1997 Aug;156(2 Pt 1):536-41. PMID: 9279236.
19. Patel IS, Vlahos I, Wilkinson TM, Lloyd-Owen SJ, Donaldson GC, Wilks M, et al. Bronchiectasis, exacerbation indices, and inflammation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2004 Aug 15;170(4):400-7. Epub 2004 May 6. PMID: 15130905.
20. O'Brien C, Guest PJ, Hill SL and Stockley RA. Physiological and radiological characterisation of patients diagnosed with chronic obstructive pulmonary disease in primary care. Thorax. 2000 Aug;55(8):635-42. PMID: 10899238; PMCID: PMC1745831.
21. O Kurtulgan, M Ahmet, U Meral. Kronik obstrüktif akciğer hastalığında ekspiratuar yüksek rezolüsyonlu bilgisayarlı tomografi bulguları ile trakeal indeks ve solunum fonksiyon testleri arasındaki ilişki 2012. Dicle Tıp Dergisi, 39(1), 42-48.
22. Halpin DMG, Criner GJ, Papi A, Singh D, Anzueto A, Martivez FJ, et al. Global Initiative for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease. The 2020 GOLD Science Committee Report on COVID-19 and Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2021 Jan 1;203(1):24-36. PMID: 33146552; PMCID: PMC7781116.
23. Kuyucu T, Güçlü SZ, Saylan B, Demir C, Senol T, Güner S, et al; Turkey SUNRISE Study Group. A cross-sectional observational study to investigate daily symptom variability, effects of symptom on morning activities and therapeutic expectations of patients and physicians in COPD-SUNRISE study. Tuberk Toraks. 2011;59(4):328-39. PMID: 22233302.
24. Donaldson GC, Seemungal TA, Bhowmik A and Wedzicha JA. Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax. 2002 Oct;57(10):847-52. doi: 10.1136/thorax.57.10.847. Erratum in: Thorax. 2008 Aug;63(8):753. PMID: 12324669; PMCID: PMC1746193.
25. Gudmundsson G, Gislason T, Janson C, Lindberg E, Hallin R, Ulrik CS, et al. Risk factors for rehospitalisation in COPD: role of health status, anxiety and depression. Eur Respir J. 2005 Sep;26(3):414-9. PMID: 16135721.
26. Atasever A, Erdinç E. KOAH’da yaşam kalitesinin değerlendirilmesi 2003. Tüberküloz ve Toraks Dergisi, 51(4), 446-55.
27. Akbay S, Kurt B, Ertürk A, Gülhan M and Çapan N. Kronik obstrüktif akciğer hastalığında yaşam kalitesi ve solunum fonksiyon testi ile ilişkisi 2001. Tüberküloz ve Toraks Dergisi, 49(3), 338-44.
28. Kütükcü EÇ, Arıkan H, Sağlam M, Yağlı NV, Deniz İNAL, Öksüz Ç, et al. Kronik obstrüktif akciğer hastalarında çok boyutlu hastalık şiddeti ve günlük yaşam aktiviteleri arasındaki ilişkinin incelenmesi 2015. Journal of Exercise Therapy and Rehabilitation, 2(2), 53-60.
29. Sevgili S, Hasanoğlu H C, Karalezli A and Er M. Bronchial reversibility in the patients with bronchiectasis 2009. Tuberkuloz ve toraks, 57(1), 38-47.
30. Demir G, Akkoca O, Doğan R, Saryal S and Karabıyıkoğlu G. KOAH'da dispne ve yaşam kalitesinin değerlendirilmesi [The evaluation of dyspnea and quality of life in COPD]. Tuberk Toraks. 2003;51(4):365-72. Turkish. PMID: 15143383.
31. Başyiğit İ. KOAH tanımı ve klinik özellikleri 2010. TTD Toraks Cerrahisi Bülteni, 1(2), 102-104.
32. Miyazaki M, Nakamura H, Chubachi S, Sasaki M, Haraguchi M, Yoshida S, et al; Keio COPD Comorbidity Research (K-CCR) Group. Analysis of comorbid factors that increase the COPD assessment test scores. Respir Res. 2014 Feb 6;15(1):13. PMID: 24502760; PMCID: PMC3922022.
33. Cömert SŞ, Müzeyyen, ERK, Müsellim B and Küçükusta AR. Kronik Obstrüktif Akciğer Hastaliğinda Yaşam Kalitesini Etkileyen Fonksiyonel Ve Antropometrik Parametreler. İzmir Göğüs Hastanesi Dergisi, 25(2), 89-100.
34. Lee AL, Button BM, Ellis S, Stirling R, Wilson JW, Holland AE, et al. Clinical determinants of the 6-Minute Walk Test in bronchiectasis. Respir Med. 2009 May;103(5):780-5. doi: 10.1016/j.rmed.2008.11.005. Epub 2008 Dec 12. PMID: 19070473.

There are 34 citations in total.

Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	Articles
Authors	Cansu Yılmaz This is me 0000-0002-8443-7562 Murat Acat 0000-0002-7163-4882 Serkan Öner 0000-0002-7802-880X Habibe İnci 0000-0003-2883-259X Didem Adahan 0000-0003-3389-2730
Project Number	yok
Publication Date	June 29, 2022
Acceptance Date	June 1, 2022
Published in Issue	Year 2022 Volume: 14 Issue: 2

Cite

APA	Yılmaz, C., Acat, M., Öner, S., İnci, H., et al. (2022). Evaluation of the Effect of Comorbid Bronchiectasis on Quality of Life in Patients with Chronic Obstructive Pulmonary Disease. Konuralp Medical Journal, 14(2), 357-365. https://doi.org/10.18521/ktd.997761
AMA	Yılmaz C, Acat M, Öner S, İnci H, Adahan D. Evaluation of the Effect of Comorbid Bronchiectasis on Quality of Life in Patients with Chronic Obstructive Pulmonary Disease. Konuralp Medical Journal. June 2022;14(2):357-365. doi:10.18521/ktd.997761
Chicago	Yılmaz, Cansu, Murat Acat, Serkan Öner, Habibe İnci, and Didem Adahan. “Evaluation of the Effect of Comorbid Bronchiectasis on Quality of Life in Patients With Chronic Obstructive Pulmonary Disease”. Konuralp Medical Journal 14, no. 2 (June 2022): 357-65. https://doi.org/10.18521/ktd.997761.
EndNote	Yılmaz C, Acat M, Öner S, İnci H, Adahan D (June 1, 2022) Evaluation of the Effect of Comorbid Bronchiectasis on Quality of Life in Patients with Chronic Obstructive Pulmonary Disease. Konuralp Medical Journal 14 2 357–365.
IEEE	C. Yılmaz, M. Acat, S. Öner, H. İnci, and D. Adahan, “Evaluation of the Effect of Comorbid Bronchiectasis on Quality of Life in Patients with Chronic Obstructive Pulmonary Disease”, Konuralp Medical Journal, vol. 14, no. 2, pp. 357–365, 2022, doi: 10.18521/ktd.997761.
ISNAD	Yılmaz, Cansu et al. “Evaluation of the Effect of Comorbid Bronchiectasis on Quality of Life in Patients With Chronic Obstructive Pulmonary Disease”. Konuralp Medical Journal 14/2 (June 2022), 357-365. https://doi.org/10.18521/ktd.997761.
JAMA	Yılmaz C, Acat M, Öner S, İnci H, Adahan D. Evaluation of the Effect of Comorbid Bronchiectasis on Quality of Life in Patients with Chronic Obstructive Pulmonary Disease. Konuralp Medical Journal. 2022;14:357–365.
MLA	Yılmaz, Cansu et al. “Evaluation of the Effect of Comorbid Bronchiectasis on Quality of Life in Patients With Chronic Obstructive Pulmonary Disease”. Konuralp Medical Journal, vol. 14, no. 2, 2022, pp. 357-65, doi:10.18521/ktd.997761.
Vancouver	Yılmaz C, Acat M, Öner S, İnci H, Adahan D. Evaluation of the Effect of Comorbid Bronchiectasis on Quality of Life in Patients with Chronic Obstructive Pulmonary Disease. Konuralp Medical Journal. 2022;14(2):357-65.

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