Advanced age is widely believed to be a risk factor for acute exacerbations in patients with bronchiectasis. However, few data exist supporting this association.
Data were obtained from a medical claims database containing information from >30 US health plans with a combined membership of >10 million lives annually. Study subjects consisted of all patients aged ≥18 years with diagnoses of bronchiectasis between July 1998 and June 2002 and continuous medical coverage between July 2002 and June 2003 (“follow-up”); patients with cystic fibrosis were excluded. Study subjects were stratified based on age (<65 vs ≥65 years). Acute exacerbations were defined to consist of respiratory hospitalizations and respiratory-related outpatient encounters with subsequent receipt of antibiotic therapy, and were identified during the one-year period of follow-up. Bivariate analyses were undertaken to examine the relationship between risk of acute exacerbations and age; statistical comparisons were performed using a chi-square test.
A total of 667 persons were identified who met study entrance criteria (age <65 years, n= 490; age ≥65 years, n=177). Mean (±SD) age among those <65 years was 52 (±10); among those ≥65 years, it was 76 (±8). During the one-year follow-up period, the percentage of patients experiencing one or more acute exacerbations did not differ by age (32.9% for age <65 years vs. 32.8% for age ≥65 years, p=0.98). The risks of respiratory hospitalization (9.2% vs. 10.7% respectively, p=0.55) and respiratory-related outpatient encounters with subsequent receipt of antibiotic therapy (29.2% vs. 27.1%, p=0.60) also did not differ across age groups.
Risk of acute exacerbations among patients with bronchiectasis does not differ by age.
Our study suggests that age is not important in predicting the risk of acute exacerbations in patients with bronchiectasis.
Derek Weycker, Grant monies (from industry related sources) Funding for this research was provided by Chiron BioPharmaceuticals to Policy Analysis Inc. (PAI), an independent contract research organization.