P0575 Bronchiectasis in patients with inflammatory bowel disease – prevalence, predictors, and clinical characteristics

Abstract Background Inflammatory bowel diseases (IBD) are known to be associated with bronchiectasis (BE). However, data detailing the prevalence of BE among patients with IBD (IBD-BE), its risk factors, and clinical characteristics are limited. Methods This was a single center retrospective study including patients who visited an IBD unit at a tertiary center between 2022 and 2023. Data on prior chest CT scans was extracted. Radiologists blinded to clinical data analyzed all chest CT scans for BE. The overall prevalence of IBD-BE was estimated using multiple imputation analysis. Risk factors were analyzed in the whole cohort and after matching. Results 1637 patients with IBD were included, 254 had prior chest CT scans, of these, 30 (1.8% of the cohort) had BE. The estimated overall prevalence of IBD-BE was 4.7% (95% CI 3.6-5.8%). Demographic and clinical characteristics are detailed in Table 1. In a multivariate logistic regression analysis, older age (adjusted odds ratio (aOR) 1.04, 95% confidence interval (CI) 1.02-1.06 for every additional year, p<0.001), UC diagnosis (aOR 2.31, 95% CI 1.08-4.92, p=0.029), and IBD-related surgery (aOR 2.71, 95% CI 1.23-5.96, p=0.013) remained independent predictors for IBD-BE. The IBD-BE group also had more extraintestinal manifestations (EIMs) in general (57% vs. 31%, p=0.01), and specifically arthritis (33% vs. 14%, p=0.02) and non-arthritis (33% vs. 19%, p=0.1) involvement. Radiological and clinical features of patients with IBD-BE are detailed in Figure 1. Interestingly, of patients with IBD-BE, 63% had evidence of BE in the chest cuts of their prior abdominal CT scans, and 70% had relevant respiratory symptoms. Despite this, most did not see a pulmonologist nor receive BE-related therapy. Clinical characteristics and outcomes of IBD-BE were similar to those of patients with non-IBD-related BE. Conclusion This study shows a minimal prevalence of 1.8% and an estimated 4.7% overall prevalence of BE in patients with IBD. Risk factors associated with IBD-BE included older age, a diagnosis of UC, IBD-related surgery and the presence of EIMs. The low rates of BE-directed therapy and pulmonology referral indicate the need for a higher degree of suspicion and timely referral.