High Prevalence of Bronchiectasis in Adults: Analysis of CT Findings in a Health Screening Program

Kwak, Hyun Jung; Moon, Ji-Yong; Choi, Yo Won; Kim, Tae Hyung; Yoon, Ho Joo; Shin, Dong Ho; Park, Sung Soo; Kim, Sang‐Heon

doi:10.1620/tjem.222.237

Cited by 70 publications

(61 citation statements)

References 25 publications

(41 reference statements)

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“…In agreement with the later study by Seitz and co-workers, our average annual age-adjusted hospitalization rate for bronchiectasis as the primary diagnosis was 1.8 per 100,000 population, with an increasing trend that was most pronounced among females with bronchiectasis as the primary diagnosis [8]. Hospitalization rates were generally higher among aged subjects, as reported previously [2], [5], [6], [8].…”

Section: Discussionsupporting

confidence: 92%

“…Between 2005 and 2011, on average 48% of the total male, but only 43% of the total female German population aged ≥65 years (and 60% vs. 54% among those aged ≥75 years) had been hospitalized (data not shown), despite a clear predominance of females in this subpopulation [15]. This suggests that, although the most pronounced increases of hospitalization rates were observed among females, bronchiectasis may still be underdiagnosed among the more advanced age groups in Germany, particularly among elderly women [6]. On the one hand, this argues against more severe disease and frequent readmissions among the more advanced age groups.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2013

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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.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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

et al. 2013

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“…These differences may partly explain the disparities found in the reported prevalence. Moreover, most of these studies excluded patients with previously known bronchiectasis and those with bronchiectasis in only one pulmonary segment, as this circumstance can be found in a significant percentage of elderly people in the general population, or in smokers with no airway obstruction 29. Recently, Tan et al30 found that 19.9% of healthy individuals had bronchiectasis compared with 35.1% of severe COPD patients of the same age.…”

Section: Prevalence Of Bronchiectasis In Copdmentioning

confidence: 99%

Bronchiectasis in COPD patients: more than a comorbidity?

Martínez-García

Miravitlles

2017

COPD

117

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Computed tomography scan images have been used to identify different radiological COPD phenotypes based on the presence and severity of emphysema, bronchial wall thickening, and bronchiectasis. Bronchiectasis is defined as an abnormal dilation of the bronchi, usually as a result of chronic airway inflammation and/or infection. The prevalence of bronchiectasis in patients with COPD is high, especially in advanced stages. The identification of bronchiectasis in COPD has been defined as a different clinical COPD phenotype with greater symptomatic severity, more frequent chronic bronchial infection and exacerbations, and poor prognosis. A causal association has not yet been proven, but it is biologically plausible that COPD, and particularly the infective and exacerbator COPD phenotypes, could be the cause of bronchiectasis without any other known etiology, beyond any mere association or comorbidity. The study of the relationship between COPD and bronchiectasis could have important clinical implications, since both diseases have different and complementary therapeutic approaches. Longitudinal studies are needed to investigate the development of bronchiectasis in COPD, and clinical trials with treatments aimed at reducing bacterial loads should be conducted to investigate their impact on the reduction of exacerbations and improvements in the long-term evolution of the disease.

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“…[6,29,30] A population survey in China (n = 66,546) [31] demonstrated that the prevalence of tuberculosis infection was about 44.5% (29,557/66,546) when a positive response to purified protein derivative (PPD)-RT23 (≥6 mm) was used as the diagnostic criterion. More recently, a prospective cohort study of rural residents in China (n = 21,022) [32] showed that the rate of latent tuberculosis infection, determined by a positive result of IFN-γ release assay, was 19%.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with bronchiectasis in patients with moderate–severe chronic obstructive pulmonary disease

Jin¹,

et al. 2016

Medicine

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A high prevalence of bronchiectasis was found by chest computed tomography (CT) in patients with moderate–severe chronic obstructive pulmonary disease (COPD), and it was shown to be associated with more severe symptoms, higher frequency of exacerbations and mortality. The risk factors for bronchiectasis in COPD are not yet clarified.High-resolution computed tomography (HRCT) of chest was performed in patients with moderate–severe COPD, and the presence and the extent of bronchiectasis were evaluated by two radiologists. Demographic data, respiratory symptoms, lung function, previous pulmonary tuberculosis, serum inflammatory markers, serum total immunoglobulin E (T-IgE), and sputum culture of Pseudomonas aeruginosa were compared between those with and without bronchiectasis. Multivariate logistic regression analysis was used to determine the independent factors associated with bronchiectasis.We enrolled 190 patients with stable COPD, of which 87 (87/190, 45.8%) had bronchiectasis on HRCT. Compared with those without bronchiectasis, COPD patients with bronchiectasis were more likely to be males (P = 0.021), had a lower body mass index (BMI) (P = 0.019), a higher prevalence of previous tuberculosis (P = 0.005), longer history of dyspnea (P < 0.001), more severe dyspnea (P = 0.041), higher frequency of acute exacerbation (P = 0.002), higher serum concentrations of C-reactive protein (CRP) (P = 0.017), fibrinogen (P = 0.016), and T-IgE [P = 0.004; for log10(T-IgE), P <0.001]. COPD patients with bronchiectasis also showed poorer lung function (for FEV1/FVC, P = 0.013; for FEV1%predicted, P = 0.012; for global initiative for chronic obstructive lung disease (GOLD) grades, P = 0.035), and a higher positive rate of sputum P aeruginosa (P = 0.020). Logistic regression analysis demonstrated that male gender (P = 0.021), previous tuberculosis (P = 0.021), and increased level of serum T-IgE [for log10(T-IgE), P < 0.001] were risk factors for coexistent bronchiectasis. More notably, the level of serum T-IgE [log10(T-IgE)] was positively correlated with the extent of bronchiectasis in COPD patients (r = 0.208, P = 0.05).Higher serum T-IgE, male gender, and previous tuberculosis are independent risk factors for coexistent bronchiectasis in COPD. The association of T-IgE with the extent of bronchiectasis also suggests that further investigations are needed to explore the potential role of IgE in the pathogenesis of bronchiectasis in COPD.

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High Prevalence of Bronchiectasis in Adults: Analysis of CT Findings in a Health Screening Program

Cited by 70 publications

References 25 publications

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

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

Bronchiectasis in COPD patients: more than a comorbidity?

Factors associated with bronchiectasis in patients with moderate–severe chronic obstructive pulmonary disease

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