Increasing prevalence and burden of bronchiectasis in urban Chinese adults, 2013-2017: a nationwide population-based cohort study

Abstract

Background: While the prevalence and disease burden of bronchiectasis are increasing, data in the world's largest population are lacking. We aimed to investigate the prevalence and disease burden of bronchiectasis in Chinese adults.

Methods: We conducted a population-based study using data between 2013 and 2017 from the national databases of Urban Employee Basic Medical Insurance and Urban Resident Basic Medical Insurance in China. Data from over 380 million patients aged 18 years and older during the study period were analyzed, and a total of 383,926 bronchiectasis patients were identified. Primary outcomes included the age- and sex-specific prevalence of bronchiectasis. Annual visits and hospitalizations, as well as annual costs were also calculated.

Results: The prevalence of bronchiectasis in Chinese adults increased 2.31-fold, from 75.48 (62.26, 88.69) per 100,000 in 2013 to 174.45 (137.02, 211.88) per 100,000 in 2017. The increase was more remarkable for patients aged over 50 years in both genders. The per-capita total cost and hospitalization cost of patients with bronchiectasis increased 2.18-fold and 1.83-fold from 2013 to 2017, respectively, mostly driven by non-bronchiectasis costs. The average annual hospitalization ranged from 1.20 to 1.24 times during the 5 years.

Conclusion: The prevalence and disease burden of bronchiectasis in Chinese urban adults ≥ 18 years had increased significantly between 2013 and 2017.

Keywords: Bronchiectasis; Disease burden; Prevalence.

Fig. 1

Flow chart of case ascertainment for bronchiectasis

Fig. 2

Crude prevalence, adjusted prevalence of bronchiectasis. (units: /100,000 person-years)

Fig. 3

Crude prevalence of bronchiectasis in population grouped by sex–age group (units: /100,000 person-years). a Trends in bronchiectasis prevalence for female. b Trends in bronchiectasis prevalence for male