Background:
Bronchiectasis is a potentially serious condition characterized by permanent and abnormal widening of the airways, the prevalence of which is not well described. We sought to describe the trends, associated conditions, and risk factors for bronchiectasis among adults aged ≥ 65 years.
Methods:
A 5% sample of the Medicare outpatient claims database was analyzed for bronchiectasis trends among beneficiaries aged ≥ 65 years from 2000 to 2007. Bronchiectasis was identified using International Classification of Diseases, Ninth Revision, Clinical Modification claim diagnosis codes for acquired bronchiectasis. Period prevalence was used to describe sex- and race/ethnicity-specific rates, and annual prevalence was used to describe trends and age-specific rates. We estimated trends using Poisson regression and odds of bronchiectasis using multivariate logistic regression.
Results:
From 2000 to 2007, 22,296 people had at least one claim for bronchiectasis. The 8-year period prevalence of bronchiectasis was 1,106 cases per 100,000 people. Bronchiectasis increased by 8.7% per year. We identified an interaction between the number of thoracic CT scans and race/ethnicity; period prevalence varied by a greater degree by number of thoracic CT scans among Asians compared with whites or blacks. Among people with one CT scan, Asians had a 2.5- and 3.9-fold higher period prevalence compared with whites and blacks.
Conclusions:
Bronchiectasis prevalence increased significantly from 2000 to 2007 in the Medicare outpatient setting and varied by age, sex, and race/ethnicity. This increase could be due to a true increase in the condition or an increased recognition of previously undiagnosed cases.
From the Epidemiology Unit (Ms Seitz and Drs Olivier, Adjemian, and Prevots) and Laboratory of Clinical Infectious Diseases (Ms Seitz and Drs Olivier, Adjemian, Holland, and Prevots), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD.Correspondence to: Amy E. Seitz, MPH, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 8 W Dr, MSC 2665, Bethesda, MD 20892; e-mail: seitza@niaid.nih.gov
Author contributions: Ms Seitz and Dr Prevots had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Ms Seitz: contributed to the study concept and design; data acquisition and management; statistical and epidemiologic analyses; interpretation of results; drafting of the manuscript; and manuscript preparation, revision, final edit, and approval of the final version.
Dr Olivier: contributed to the study concept and design; interpretation of results; and manuscript preparation, revision, final edit, and approval of the final version.
Dr Adjemian: contributed to the interpretation of results and manuscript preparation, revision, final edit, and approval of the final version.
Dr Holland: contributed to the interpretation of results and manuscript preparation, revision, final edit, and approval of the final version.
Dr Prevots: contributed to the study concept and design; data acquisition and management; statistical and epidemiologic analyses; interpretation of results; drafting of the manuscript; and manuscript preparation, revision, final edit, and approval of the final version.
Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Role of sponsors: This research was completed as part of the NIH intramural research program. The authors had full control in the design of the study, analysis of the data, and preparation of the manuscript. The views expressed in this article are those of the authors and do not necessarily reflect those of the US Department of Health and Human Services.
Additional information: The e-Appendix can be found in the “Supplemental Materials” area of the online article.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.Funding/Support: This research was supported by the Intramural Research Program of the National Institutes of Health, National Institute of Allergy and Infectious Diseases.