Trends in bronchiectasis among medicare beneficiaries in the United States, 2000 to 2007.
BACKGROUND
Bronchiectasis is a potentially serious condition characterized by permanent and abnormal widening of the airways, the prevalence of which is not well described. We sought to describe the trends, associated conditions, and risk factors for bronchiectasis among adults aged ≥ 65 years.


METHODS
A 5% sample of the Medicare outpatient claims database was analyzed for bronchiectasis trends among beneficiaries aged ≥ 65 years from 2000 to 2007. Bronchiectasis was identified using International Classification of Diseases, Ninth Revision, Clinical Modification claim diagnosis codes for acquired bronchiectasis. Period prevalence was used to describe sex- and race/ethnicity-specific rates, and annual prevalence was used to describe trends and age-specific rates. We estimated trends using Poisson regression and odds of bronchiectasis using multivariate logistic regression.


RESULTS
From 2000 to 2007, 22,296 people had at least one claim for bronchiectasis. The 8-year period prevalence of bronchiectasis was 1,106 cases per 100,000 people. Bronchiectasis increased by 8.7% per year. We identified an interaction between the number of thoracic CT scans and race/ethnicity; period prevalence varied by a greater degree by number of thoracic CT scans among Asians compared with whites or blacks. Among people with one CT scan, Asians had a 2.5- and 3.9-fold higher period prevalence compared with whites and blacks.


CONCLUSIONS
Bronchiectasis prevalence increased significantly from 2000 to 2007 in the Medicare outpatient setting and varied by age, sex, and race/ethnicity. This increase could be due to a true increase in the condition or an increased recognition of previously undiagnosed cases.
Epidemiology Unit, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD. Electronic address: seitza@niaid.nih.gov.
Amy E
AE
Seitz
Epidemiology Unit, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD.
Kenneth N
KN
Olivier
Epidemiology Unit, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD.
Jennifer
J
Adjemian
Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD.
Steven M
SM
Holland
Epidemiology Unit, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD.
D Rebecca
DR
Prevots
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001987:Bronchiectasis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D006278:Medicare; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*