• Internal medicine journal · Jun 2012

    Socioeconomic deprivation, readmissions, mortality and acute exacerbations of bronchiectasis.

    • M E Roberts, L Lowndes, D G Milne, and C A Wong.
    • Nottingham University Hospitals, Nottingham, UK.
    • Intern Med J. 2012 Jun 1; 42 (6): e129e136e129-36.

    BackgroundBronchiectasis is known to cause significant morbidity in children in New Zealand. Little is known of the disease in adults.AimOur objective was to characterise a cohort of adults who presented to hospital with acute exacerbations of the disease.MethodsWe retrospectively collected information on all exacerbations treated as inpatients from a single hospital in South Auckland, New Zealand during 2002.ResultsWe collected information on 307 exacerbations in 152 patients. Twenty-seven per cent were of Maaori ethnic origin, and 44% Pacific. Seventy per cent lived in areas categorised as the 20% most deprived in New Zealand. Comorbid conditions were present in 80% of patients - most commonly chronic obstructive pulmonary disease, asthma, diabetes and cardiac disease. Seventy (46%) patients had at least one readmission and 32 patients (21%) died within 12 months of admission to hospital. Greater deprivation was associated with increased mortality at 12 months after admission after adjusting for other factors (OR 11, 95% CI 2.0-61, P= 0.006). In the subgroup who underwent high-resolution computed tomographic scanning (93), increasing severity of bronchiectasis (modified Bhalla score) was associated with readmission within 12 months (P= 0.004), but not mortality (P= 0.419).ConclusionsWe have shown that exacerbations of bronchiectasis in South Auckland are more common in patients who are predominantly of Maaori or Pacific descent and are socioeconomically deprived. Admission to hospital for an exacerbation is associated with high readmission and mortality rates.© 2011 The Authors. Internal Medicine Journal © 2011 Royal Australasian College of Physicians.

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