Bronchiectasis in indigenous and non-indigenous residents of Australia and New Zealand

Blackall, Sean R., Hong, Jae B., King, Paul, Wong, Conroy, Einsiedel, Lloyd, Rémond, Marc G.W., Woods, Cindy, and Maguire, Graeme P. (2018) Bronchiectasis in indigenous and non-indigenous residents of Australia and New Zealand. Respirology, 23 (8). pp. 743-749.

[img] PDF (Published Version) - Published Version
Restricted to Repository staff only

View at Publisher Website: https://doi.org/10.1111/resp.13280
 
4
1


Abstract

Background and objective: Bronchiectasis not associated with cystic fibrosis is an increasingly recognized chronic lung disease. In Oceania, indigenous populations experience a disproportionately high burden of disease. We aimed to describe the natural history of bronchiectasis and identify risk factors associated with premature mortality within a cohort of Aboriginal Australians, New Zealand Māori and Pacific Islanders, and non-indigenous Australians and New Zealanders. Methods: This was a retrospective cohort study of bronchiectasis patients aged >15 years at three hospitals: Alice Springs Hospital and Monash Medical Centre in Australia, and Middlemore Hospital in New Zealand. Data included demographics, ethnicity, sputum microbiology, radiology, spirometry, hospitalization and survival over 5 years of follow-up. Results: Aboriginal Australians were significantly younger and died at a significantly younger age than other groups. Age- and sex-adjusted all-cause mortality was higher for Aboriginal Australians (hazard ratio (HR): 3.9), and respiratory-related mortality was higher for both Aboriginal Australians (HR: 4.3) and Māori and Pacific Islander people (HR: 1.7). Hospitalization was common: Aboriginal Australians had 2.9 admissions/person-year and 16.9 days in hospital/person-year. Despite Aboriginal Australians having poorer prognosis, calculation of the FACED score suggested milder disease in this group. Sputum microbiology varied with Aspergillus fumigatus more often isolated from non-indigenous patients. Airflow obstruction was common (66.9%) but not invariable. Conclusions: Bronchiectasis is not one disease. It has a significant impact on healthcare utilization and survival. Differences between populations are likely to relate to differing aetiologies and understanding the drivers of bronchiectasis in disadvantaged populations will be key.

Item ID: 58611
Item Type: Article (Research - C1)
ISSN: 1440-1843
Keywords: bronchiectasis, hospitalization, Oceania, premature mortality, survival analysis
Copyright Information: © 2018 Asian Pacific Society of Respirology
Date Deposited: 13 Jun 2019 03:41
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110203 Respiratory Diseases @ 100%
Downloads: Total: 1
Last 12 Months: 1
More Statistics

Actions (Repository Staff Only)

Item Control Page Item Control Page