title: Socioeconomic deprivation, readmissions, mortality and acute exacerbations of bronchiectasis.
abstract: BACKGROUND
  Bronchiectasis is known to cause significant morbidity in children in New Zealand. Little is known of the disease in adults.
  
  
  OBJECTIVE
  Our objective was to characterise a cohort of adults who presented to hospital with acute exacerbations of the disease.
  
  
  METHODS
  We retrospectively collected information on all exacerbations treated as inpatients from a single hospital in South Auckland, New Zealand during 2002.
  
  
  RESULTS
  We 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).
  
  
  CONCLUSIONS
  We 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.
authors.affiliation: Nottingham University Hospitals, Nottingham, UK.
authors.forename: M E
authors.initials: ME
authors.lastname: Roberts
authors.forename: L
authors.initials: L
authors.lastname: Lowndes
authors.forename: D G
authors.initials: DG
authors.lastname: Milne
authors.forename: C A
authors.initials: CA
authors.lastname: Wong
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D001987:Bronchiectasis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality; D018450:Disease Progression; D010359:Patient Readmission / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014057:Tomography, X-Ray Computed