Early onset severe disease and premature mortality in Indigenous Australians with non-cyctic fibrosis bronchiectasis

Blackall, S., Woods, C., Einsiedel, L., King, P., and Maguire, G. (2015) Early onset severe disease and premature mortality in Indigenous Australians with non-cyctic fibrosis bronchiectasis. Respirology, 20 (Supplement S2). p. 126.

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Aim: To describe the natural history of adult non-cystic fibrosis bronchiectasis (non-CF BEx) and identify risk factors associated with premature mortality within a cohort of Indigenous and non-Indigenous Australians.

Methods: A retrospective cohort study of Indigenous and non-Indigenous Australians with non-CF bronchiectasis from January 1 2009 until January 15 2014. Five-year survival was determined and multivariate Cox proportional hazard modelling used to identify independent predictors of mortality. Results: 85 Indigenous (all Aboriginal Australian) and 79 non-Indigenous Australian adults were included. Aboriginal Australian non-CF BEx patients were younger (mean age 43.7 ± 12.3, SD versus mean age 59.4 ± 17.5 in non-Indigenous Australians, p < 0.001) and had more severely impaired lung function with lower FEV1% (median 30.0 (IQR 20.0-37.0) compared with median 48.0 (39.0-81.0, p < 0.001) and FVC % predicted (median 41.0 (31.5-48.0) compared with 65.0 (48.0-93.0, p < 0.001 ). Frve-year respiratory-related survival in Aboriginal Australians was poorer (log rank, p = 0.029). Factors independently associated with poorer respiratory-related survival were; being Aboriginal Australian (HR 4.12, 95°0 Cl 1.71-9.94, p = 0.002), increasing age (HR 1.04/year, 95% Cl 1.01-1.07, p = 0.012). male gender (HR 2.75, 95% Cl 1.32-5.76, p=0.007) and more lobes affected (HR 1.31/additional lobe, 95% Cl 1.05-1.64, p = 0.018).

Conclusion: Indigenous Australians with non-CF bronchrectasis experience severe early onset non-CF bronchiectasis that ultimately leads to premature respiratory-related mortality compared to non-Indigenous Australians. This has implications for both prevention and management.

Item ID: 42084
Item Type: Article (Abstract)
ISSN: 1440-1843
Funders: James Cook University (JCU)
Projects and Grants: JCU School of Medicine and Dentistry
Date Deposited: 22 Mar 2016 03:49
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110203 Respiratory Diseases @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920115 Respiratory System and Diseases (incl. Asthma) @ 50%
92 HEALTH > 9203 Indigenous Health > 920302 Aboriginal and Torres Strait Islander Health - Health Status and Outcomes @ 50%
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