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Obstructive Lung Diseases |

Is Age Associated With Different Bronchiectasis Etiologies? FREE TO VIEW

Paola Faverio, MD; Diego Maselli, MD; Alejandro Arango, DDS; Juan Fernandez, MD; Marcos Restrepo, MD
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University of Texas Health Science Center at San Antonio, San Antonio, TX


Chest. 2014;145(3_MeetingAbstracts):412A. doi:10.1378/chest.1836696
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Abstract

SESSION TITLE: Bronchiectasis Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: Bronchiectasis is a heterogeneous disease with a wide range of etiological factors and associated conditions. Limited data are available regarding differences of bronchiectasis etiology in different age groups. Our aim was to describe the differences in etiologies and comorbidities related to bronchiectasis between elderly (≥ 60 years) and younger patients.

METHODS: We performed a Quality Improvement project on patients referred to a subspecialty clinic at two tertiary teaching outpatient clinics in San Antonio, TX, USA. This project included a pre-interventional assessment of the tests and methodologies used by clinicians in their practice to identify conditions associated with bronchiectasis. We stratified the bronchiectasis cohort in two groups according to age: Elderly (>60 years of age) and Younger (18-59 years of age). All patients required a chest computerized tomography to confirm the bronchiectasis diagnosis. Associated conditions were identified through past medical history and symptoms collection and, when required, specific diagnostic tests.

RESULTS: We identified 44 patients with bronchiectasis of which 23 (52%) were ≥ 60 years old at the time of diagnosis. Elderly patients with bronchiectasis were more likely to be diagnosed with chronic obstructive pulmonary disease (COPD) (n=8 [34.8%] vs. n=1 [4.8%]; Odds ratio [OR]= 10.7; p=0.023) and previous mycobacterial infection including tuberculosis, Mycobacterium avium complex and non-tuberculous mycobacteria (n=10 [43.5%] vs. n=2 [9.5%], OR= 7.3; p=0.017) compared to younger patients. However, elderly patients with bronchiectasis were less likely to be associated with connective tissue disorder (n=1 [4.3%] vs. n=6 [28.6%]; OR= 0.11; p=0.042) compared to younger patients. Only 16% of all bronchiectasis remained Idiopathic and they were equally distributed in the two groups.

CONCLUSIONS: Our results suggest that bronchiectasis in elderly patients are more likely to be associated with COPD and previous mycobacterial infection, but less likely to be associated with connective tissue disorder.

CLINICAL IMPLICATIONS: Age and symptoms may determine the degree of work-up necessary to diagnose the cause of bronchiectasis. Future epidemiological studies should further investigate the differences between age groups.

DISCLOSURE: The following authors have nothing to disclose: Paola Faverio, Diego Maselli, Alejandro Arango, Juan Fernandez, Marcos Restrepo

No Product/Research Disclosure Information


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