Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.
PLoS One. 2013 Aug 1;8(8):e71109. doi: 10.1371/journal.pone.0071109. Print 2013.
Representative population-based data on the epidemiology of bronchiectasis in Europe are limited. The aim of the present study was to investigate the current burden and the trends of bronchiectasis-associated hospitalizations and associated conditions in Germany in order to inform focused patient care and to facilitate the allocation of healthcare resources.
The nationwide diagnosis-related groups hospital statistics for the years 2005-2011 were used in order to identify hospitalizations with bronchiectasis as any hospital discharge diagnosis according to the International Classification of Diseases, 10th revision, code J47, (acquired) bronchiectasis. Poisson log-linear regression analysis was used to assess the significance of trends. In addition, the overall length of hospital stay (LOS) and the in-hospital mortality in comparison to the nationwide overall mortality due to bronchiectasis as the primary diagnosis was assessed.
Overall, 61,838 records with bronchiectasis were extracted from more than 125 million hospitalizations. The average annual age-adjusted rate for bronchiectasis as any diagnosis was 9.4 hospitalizations per 100,000 population. Hospitalization rates increased significantly during the study period, with the highest rate of 39.4 hospitalizations per 100,000 population among men aged 75-84 years and the most pronounced average annual increases among females. Besides numerous bronchiectasis-associated conditions, chronic obstructive pulmonary disease (COPD) was most frequently found in up to 39.2% of hospitalizations with bronchiectasis as the primary diagnosis. The mean LOS was comparable to that for COPD. Overall, only 40% of bronchiectasis-associated deaths occurred inside the hospital.
The present study provides evidence of a changing epidemiology and a steadily increasing prevalence of bronchiectasis-associated hospitalizations. Moreover, it confirms the diversity of bronchiectasis-associated conditions and the possible association between bronchiectasis and COPD. As the major burden of disease may be managed out-of-hospital, prospective patient registries are needed to establish the exact prevalence of bronchiectasis according to the specific underlying condition.
关于欧洲支气管扩张症的流行病学的代表性人群数据有限。本研究的目的是调查德国支气管扩张症相关住院治疗的现状和趋势，并确定相关情况，以便为有针对性的患者护理提供信息，并为医疗资源的分配提供便利。
利用 2005 年至 2011 年全国按诊断相关分组的医院统计数据，根据国际疾病分类第 10 版（J47 代码）确定任何支气管扩张症作为任何出院诊断的住院患者（获得性）支气管扩张症。采用泊松对数线性回归分析来评估趋势的显著性。此外，还评估了与支气管扩张症作为主要诊断相关的全国整体死亡率相比的总住院时间（LOS）和院内死亡率。
从超过 1.25 亿次住院中提取了 61838 例支气管扩张症记录。任何诊断的支气管扩张症的平均年调整发病率为每 10 万人 9.4 例住院治疗。在研究期间，住院率显著增加，其中 75-84 岁男性的住院率最高，为 39.4 例/每 10 万人，女性的年平均增长率最高。除了许多支气管扩张症相关的疾病外，慢性阻塞性肺疾病（COPD）在高达 39.2%的支气管扩张症作为主要诊断的住院患者中最常发现。平均 LOS 与 COPD 相当。总的来说，只有 40%的支气管扩张症相关死亡发生在医院内。
本研究提供了支气管扩张症流行病学变化和患病率不断增加的证据。此外，它证实了支气管扩张症相关疾病的多样性以及支气管扩张症与 COPD 之间的可能关联。由于大部分疾病负担可能在院外管理，因此需要前瞻性患者登记来根据特定的潜在疾病确定支气管扩张症的确切患病率。
