Non-cystic fibrosis bronchiectasis in Taiwan

Bronchiectasis exhibits substantial heterogeneity across geographic locations and includes a diverse range of aetiologies. Limited large-scale data are available for Southeast Asian countries.

This was a multicentre, retrospective, observational cohort study. Between January 2017 and June 2020, comprehensive clinical data were collected on enrolment, and 1-year follow-ups were conducted using an electronic case report form.

A total of 2753 patients were enrolled. The mean age of the patients was 67 years. Forty-two per cent (1150/2753) of patients were male. The mean modified Reiff score was 5.0±3.3. The proportions of bacteria, tuberculosis and nontuberculous mycobacteria cultured from sputum within 1 year of follow-up were 46% (381/829), 1% (10/829) and 24% (202/829), respectively. The most prevalent bacterial isolate was Pseudomonas aeruginosa (22%), followed by Klebsiella pneumoniae (11%). Airflow obstruction was observed in 32% of patients, and 39% used inhaled bronchodilators. A substantial proportion (57%) of the patients were prescribed mucolytics. Seventeen per cent of the patients experienced severe exacerbations within a year. One-year all-cause mortality rate was 2% (52 of 2563 patients). Female patients demonstrated more severe imaging findings than male patients (modified Reiff score, 5.2 vs 4.6, p<0.001). However, they exhibited less obstructive lung function impairment (26% vs 40%, p<0.001), experienced fewer severe exacerbations (15% vs 20%, p=0.002) and had lower mortality rates (2% vs 5%, p<0.001). The risk of severe exacerbation and mortality increased significantly among patients older than 80 years.

Although female patients with bronchiectasis exhibited more severe imaging findings, their prognoses were better in Taiwan. Elderly patients older than 80 years had worse prognosis.