Bronchiectasis-Associated Hospitalizations in Germany, 2005–2011: A Population-Based Study of Disease Burden and Trends

Abstract

BackgroundRepresentative population-based data on the epidemiology of bronchiectasis in Europe are limited. The aim of the present study was to investigate the current burden and the trends of bronchiectasis-associated hospitalizations and associated conditions in Germany in order to inform focused patient care and to facilitate the allocation of healthcare resources.MethodsThe nationwide diagnosis-related groups hospital statistics for the years 2005–2011 were used in order to identify hospitalizations with bronchiectasis as any hospital discharge diagnosis according to the International Classification of Diseases, 10th revision, code J47, (acquired) bronchiectasis. Poisson log-linear regression analysis was used to assess the significance of trends. In addition, the overall length of hospital stay (LOS) and the in-hospital mortality in comparison to the nationwide overall mortality due to bronchiectasis as the primary diagnosis was assessed.ResultsOverall, 61,838 records with bronchiectasis were extracted from more than 125 million hospitalizations. The average annual age-adjusted rate for bronchiectasis as any diagnosis was 9.4 hospitalizations per 100,000 population. Hospitalization rates increased significantly during the study period, with the highest rate of 39.4 hospitalizations per 100,000 population among men aged 75–84 years and the most pronounced average annual increases among females. Besides numerous bronchiectasis-associated conditions, chronic obstructive pulmonary disease (COPD) was most frequently found in up to 39.2% of hospitalizations with bronchiectasis as the primary diagnosis. The mean LOS was comparable to that for COPD. Overall, only 40% of bronchiectasis-associated deaths occurred inside the hospital.ConclusionsThe present study provides evidence of a changing epidemiology and a steadily increasing prevalence of bronchiectasis-associated hospitalizations. Moreover, it confirms the diversity of bronchiectasis-associated conditions and the possible association between bronchiectasis and COPD. As the major burden of disease may be managed out-of-hospital, prospective patient registries are needed to establish the exact prevalence of bronchiectasis according to the specific underlying condition.

Bronchiectasis and increased risk of ischemic stroke: a nationwide population-based cohort study

“…A similar observation was reported in previous studies that bronchiectasis coexisted in 30%–57% of patients with COPD,45–48 which significantly increased the duration of ICU stay and hospital admission46 as well as the mortality rate 4,48. On the other hand, a Germany study showed that, with bronchiectasis as the primary diagnosis, 39% of the hospitalized patients were found to be comorbid with COPD and emphysema 49. COPD and bronchiectasis share many features in common, presenting a similar inflammatory profile with symptoms of chronic cough and sputum production, and both sometimes overlap, complicating their discriminative diagnoses and treatments 50.…”

Nontuberculous Mycobacterial Infection Is Associated with Increased Respiratory Failure: A Nationwide Cohort Study

“…COPD has a strong association with bronchiectasis in previous study [5]. Meanwhile, NTM is a potential risk factor for COPD [34].…”

Spatial and temporal variability of bronchiectasis cases in Silesian voivodeship in 2006–2010

“…Findings from Germany also show an increasing value of the standardized hospitalization rate due to bronchiectasis (from 1.6/100 000 inhabitants to 2.1/100 000 inhabitants) in the years 2006-2011. This rate was clearly higher in female than in male population (2.3/100 000 inhabitants vs. 1.4/100 000 inhabitants, respectively), and increased along with age, showing the highest value in women aged 65-74 years (7.4/100 000 inhabitants) [8].…”

“…The averaged value of the standardized mortality in Germany (study period 2006-2011) was 0.03/100 000 inhabitants, 80% of deaths due to bronchiectasis occurred in the case of people older than 65 years of age [8].…”

“…In Finland, the prevalence rate was about 0.5/100 000 inhabitants in 1998 [5]. Results of German study have confirmed that the average standardized rate of hospitalization due to bronchiectasis in the years 2005-2011 was about 1.8/100 000 inhabitants [8]. According to the data quoted by the European Lung White Book, the largest value of the standardized mortality rate due to bronchiectasis was observed in Great Britain (1.18/100 000 inhabitants), in Hungary (1.31/100 000 inhabitants) and in Ireland (0.99/100 000 inhabitants).…”