Australian adults with bronchiectasis: The first report from the Australian Bronchiectasis Registry

Simone K Visser; Peter T P Bye; Greg J Fox; Lucy D Burr; Anne B Chang; Chien-Li Holmes-Liew; Paul King; Peter G Middleton; Graeme P Maguire; Daniel Smith; Rachel M Thomson; Enna Stroil-Salama; Warwick J Britton; Lucy C Morgan

doi:10.1016/j.rmed.2019.07.016

Australian adults with bronchiectasis: The first report from the Australian Bronchiectasis Registry

Respir Med. 2019 Aug:155:97-103. doi: 10.1016/j.rmed.2019.07.016. Epub 2019 Jul 16.

Authors

Affiliations

¹ Central Clinical School Faculty of Medicine and Health, The University of Sydney, Sydney NSW 2006 and Department of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia. Electronic address: simone.visser@health.nsw.gov.au.
² Central Clinical School Faculty of Medicine and Health, The University of Sydney, Sydney NSW 2006 and Department of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia.
³ Department of Respiratory and Sleep Medicine, Mater Health, South Brisbane, QLD and Mater Research, University of Queensland, QLD, Australia.
⁴ Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Queensland University of Technology, Brisbane, Australia and Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
⁵ Department of Thoracic Medicine, Royal Adelaide Hospital, South Australia, University of Adelaide, South Australia, Australia.
⁶ Monash Respiratory and Sleep Medicine, Monash Medical Centre, Melbourne, VIC, Australia.
⁷ Department of Respiratory Medicine, Westmead Hospital, Westmead, NSW, 2145, Australia.
⁸ Western Clinical School, University of Melbourne, Melbourne Australia 3021 and General Internal Medicine, Western Health, Melbourne Australia, 3011, Australia.
⁹ The Prince Charles Hospital - Thoracic Medicine, Brisbane, Australia. QIMR Berghofer Medical Research Institute - Lung Inflammation and Infection Laboratory, Herston, Australia.
¹⁰ Department of Respiratory Medicine, Greenslopes Private Hospital, Greenslopes, QLD, 4120, Australia.
¹¹ Lung Foundation Australia, Milton, QLD, Australia.
¹² Centenary Institute, The University of Sydney, Sydney, NSW, 2006, Australia.
¹³ Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney NSW 2006 and Department of Respiratory Medicine, Concord General Repatriation Hospital, Concord, NSW, 2137, Australia.

PMID: 31326739
DOI: 10.1016/j.rmed.2019.07.016

Abstract

Background: /objective: There are no large, multi-centre studies of Australians with bronchiectasis. The Australian Bronchiectasis Registry (ABR) was established in 2015 to create a longitudinal research platform. We aimed to describe the baseline characteristics of adult ABR participants and assess the impact of disease severity and exacerbation phenotype on quality of life (QoL).

Methods: The ABR is a centralised database of patients with radiologically confirmed bronchiectasis unrelated to cystic fibrosis. We analysed the baseline data of adult patients (≥18 years).

Results: From March 2016-August 2018, 799 adults were enrolled from 14 Australian sites. Baseline data were available for 589 adults predominantly from six tertiary centres (420 female, median age 71 years (interquartile range 64-77), 14% with chronic Pseudomonas aeruginosa infection). Most patients had moderate or severe disease based on the Bronchiectasis Severity Index (BSI) (84%) and FACED (59%) composite scores. Using Global Lung function Initiative-2012 reference equations, the majority of patients (48%) had normal spirometry; only 34% had airflow obstruction (FEV₁/FVC < LLN). Disease severity scores (BSI and FACED) were negatively correlated with QoL-Bronchiectasis domain scores (r_s between -0.09 and -0.58). The frequent exacerbator phenotype (≥3 in the preceding year) was identified in 23%; this group had lower scores in all QoL-B domains (p ≤ 0.001) and more hospitalisations (p < 0.001) than those with <3 exacerbations.

Conclusions: The largest cohort of Australian adults with bronchiectasis has been described. Using contemporary criteria, most patients with bronchiectasis did not have airflow obstruction. The frequent exacerbation trait connotes poorer QoL and greater health-care utilisation.

Keywords: Bronchiectasis; Exacerbations; Phenotype; Quality of life; Registry; Respiratory function tests.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Australia
Bronchiectasis*
Cohort Studies
Disease Progression*
Female
Humans
Male
Middle Aged
Quality of Life*
Registries*
Severity of Illness Index*