title: Patients hospitalized with an infective exacerbation of bronchiectasis unrelated to cystic fibrosis: Clinical, physiological and sputum characteristics.
abstract: Bronchiectasis is a growing health burden both globally and in Australasia. Associated with repeated respiratory infections, the disease often results in hospital admission, impaired quality of life, reduced lung function and shortened life expectancy. We describe the local clinical, physiological and sputum characteristics in patients hospitalized with an infective exacerbation of bronchiectasis.
  
  
  
  This study examined the medical records of all 61 adults admitted to a metropolitan Australian hospital with an infective exacerbation of bronchiectasis in a calendar year.
  
  
  
  Baseline characteristics include: mean (SD) age of participants was 66 (14) years; 56% were women and 42% were current or ex-smokers. The majority had other coexisting medical conditions, with asthma in 44%, COPD in 59% and both asthma and COPD in 31%. Seventy-two percent were on regular inhaled medication, 23% on cyclical antibiotics and 26% undertook regular respiratory physiotherapy. Bronchodilator reversibility was present in 17% and small airway reversibility in 41%. Sputum demonstrated normal flora in 17%, Pseudomonas aeruginosa in 32%, Haemophilus influenzae in 15% and both organisms in 17%. Mean numbers of exacerbations per year requiring hospitalization was 2.3. Sixty-two percent of subjects had an Index of Relative Socio-Economic Disadvantage in deciles 1-5. Risk factors for exacerbations included a history of asthma or COPD, documented small airway reversibility and presence of P. aeruginosa.
  
  
  
  Patients hospitalized with an infective exacerbation of bronchiectasis are predominantly older with co-morbidities and of lower socio-economic status. Presence of P. aeruginosa was a risk factor for repeated exacerbations, as was a history of asthma, COPD or small airway reversibility.
authors.affiliation: Department of Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia.|Department of Respiratory Medicine, Western Health, Melbourne, Victoria, Australia.
authors.forename: Victoria
authors.initials: V
authors.lastname: Venning
authors.affiliation: Department of Respiratory Medicine, Western Health, Melbourne, Victoria, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Bartlett
authors.affiliation: Department of Respiratory Medicine, Western Health, Melbourne, Victoria, Australia.|Melbourne Medical School Western Precinct, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Lata
authors.initials: L
authors.lastname: Jayaram
mesh_terms: D000280:Administration, Inhalation; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001249:Asthma / Q000453:epidemiology*; D044362:Australasia / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D001987:Bronchiectasis / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy; D060085:Coinfection / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology; D015897:Comorbidity; D005260:Female; D005541:Forced Expiratory Volume; D006192:Haemophilus Infections / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology; D006193:Haemophilus influenzae; D006760:Hospitalization; D006801:Humans; D008297:Male; D008450:Maximal Midexpiratory Flow Rate; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011552:Pseudomonas Infections / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology; D011550:Pseudomonas aeruginosa; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D011788:Quality of Life; D012138:Respiratory Therapy; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D012923:Social Class; D013183:Sputum
chemical_list: D000900:Anti-Bacterial Agents
keywords: 
  Pseudomonas
  ; asthma; bronchiectasis; exacerbation; socio-economic