Increased mortality in patients with non cystic fibrosis bronchiectasis with respiratory comorbidities

Abstract

There are limited data regarding whether mortality is higher in patients with non cystic fibrosis bronchiectasis (bronchiectasis) than in those without bronchiectasis. Using 2005–2015 data from the Korean National Health Insurance Service, we evaluated hazard ratio (HR) for all-cause mortality in the bronchiectasis cohort relative to the matched cohort. The effect of comorbidities over the study period on the relative mortality was also assessed. All-cause mortality was significantly higher in the bronchiectasis cohort than in the matched cohort (2505/100,000 vs 2142/100,000 person-years, respectively; P < 0.001). Mortality risk was 1.15-fold greater in the bronchiectasis cohort than in the matched cohort (95% confidence interval [CI] 1.09–1.22); mortality was greatest among elderly patients (HR = 1.17, 95% CI 1.10–1.25) and men (HR = 1.19, 95% CI 1.10–1.29). Comorbidities over the study period significantly increased the risk of death in the bronchiectasis cohort relative to the matched cohort: asthma (adjusted HR = 1.20, 95% CI 1.11–1.30), chronic obstructive pulmonary disease (adjusted HR = 1.24, 95% CI 1.15–1.34), pneumonia (adjusted HR = 1.50, 95% CI 1.39–1.63), lung cancer (adjusted HR = 1.85, 95% CI 1.61–2.12), and cardiovascular disease (adjusted HR = 1.34, 95% CI 1.23–1.45). In contrast, there were no significant differences in the risk of death in patients without bronchiectasis-related comorbidities and the matched cohort, except in the case of non-tuberculous mycobacterial infection. In conclusion, all-cause mortality was higher in patients with bronchiectasis cohort than those without bronchiectasis, especially in elderly patients and men. Comorbidities over the study period played a major role in increasing mortality in patients with bronchiectasis relative to those without bronchiectasis.

Being Underweight Increases the Risk of Non-Cystic Fibrosis Bronchiectasis in the Young Population: A Nationwide Population-Based Study

“…Comorbidities that can influence the risk of bronchiectasis were also defined using the following ICD-10 codes: asthma (J45–J46), pulmonary tuberculosis (TB) (A15–A19), non-tuberculous mycobacteria (NTM) (A31) infection, diabetes mellitus (DM) (E10–E14), chronic kidney disease (CKD) (N18.1–N18.5 and N18.9), gastroesophageal reflux disease (GERD) (K21.0), solid cancer (C00–C97), connective tissue disease (M05, M06, M32, M35 and M45), hematologic malignancy (C90, C910, C920, C921, C922, C924–926, C928 and C930), transplantation (Z940, Z944, Z941 and Z942), human immunodeficiency virus infection (HIV) and acquired immune deficiency syndrome (AIDS) (B20–B24), and inflammatory bowel disease (K50–K51) [ 3 , 5 ].…”

“…The disease has been getting more attention because the worldwide prevalence of bronchiectasis has been increasing in recent years [ 2 , 3 ]. Furthermore, the disease burden of bronchiectasis, including medical costs and mortality, is substantial [ 4 , 5 ]. Early recognition and interventions to prevent disease progression in young adults could potentially decrease the disease burden of bronchiectasis.…”

Developing a Diagnostic Bundle for Bronchiectasis in South Korea: A Modified Delphi Consensus Study

“…As the prevalence and disease burden of bronchiectasis has increased worldwide [3][4][5][6] , the prevalence and disease burden of this disease has become substantial in South Korea 1,[7][8][9] . One of the obstacles to adequately addressing the disease burden of bronchiectasis is its heterogeneity 10,11 , as it may be caused by or related to many respiratory or systemic diseases 12,13 .…”

Gastro-oesophageal reflux disease increases healthcare use and medical costs in patients with bronchiectasis: a Korean nationwide population-based study

“… 1 – 3 Furthermore, disease burden in terms of healthcare use and mortality is significantly higher in patients with bronchiectasis than those without bronchiectasis. 4 – 6 Accordingly, studies evaluating factors associated with increased disease burden in bronchiectasis are urgently needed.…”