Impact of comorbidities and etiology of bronchiectasis on outcomes in hospitalised patients with bronchiectasis

Aims: Non-cystic fibrosis bronchiectasis is common in Asia and associated with significant morbidity and mortality. We sought to review etiologies and comorbidities in hospitalized patients with bronchiectasis and their impact on outcomes. Methods: We performed a retrospective review of patients admitted to our hospital between 01/01/2010 and 07/02/2011 with bronchiectasis. Data on demographics, comorbidities, bronchiectasis etiology, radiological severity, microbiology and outcomes of mortality and subsequent admissions up to 01/06/2014 were recorded. Results: 71 patients (46.5%male, mean age 68.2±12.8years) were included. 52.1% of patients had no known etiology (idiopathic), whereas 40.8% were post-infectious, of which previous Tuberculosis (TB) was the majority (35.2%). There was no statistically significant difference between idiopathic vs non-idiopathic bronchiectasis in demographic profile or radiological severity (Reiff score). Non-idiopathic patients had more non-tuberculous mycobacteria (NTM) grown from bronchoalveolar lavage (p=0.027), more frequent admissions (p=0.028) for exacerbations and higher mortality (p=0.032) during the follow-up period (mean 3.26±1.27years). 64.8% of patients had comorbidities which included cardiovascular (31%), chronic kidney disease (19.7%) and diabetes mellitus (18.3%), but there was no difference in mortality and exacerbations between patients with and without comorbidities. Conclusion: The etiology of bronchiectasis is mostly idiopathic, followed by post-TB in our population. Patients with non-idiopathic bronchiectasis had more frequent exacerbations and higher mortality. Comorbidities did not impact on mortality or exacerbations.