- Title
- Bronchiectasis in indigenous and non-indigenous residents of Australia and New Zealand
- Creator
- Blackall, Sean R.; Hong, Jae B.; King, Paul; Wong, Conroy; Einsiedel, Lloyd; Rémond, Marc G. W.; Woods, Cindy; Maguire, Graeme P.
- Relation
- Respirology Vol. 23, Issue 8, p. 743-749
- Publisher Link
- http://dx.doi.org/10.1111/resp.13280
- Publisher
- John Wiley & Sons
- Resource Type
- journal article
- Date
- 2018
- Description
- Background and objective: Bronchiectasis not associated with cystic fibrosis is an increasingly recognized chronic lung disease. In Oceania, indigenous populations experience a disproportionately high burden of disease. We aimed to describe the natural history of bronchiectasis and identify risk factors associated with premature mortality within a cohort of Aboriginal Australians, New Zealand Māori and Pacific Islanders, and non-indigenous Australians and New Zealanders. Methods: This was a retrospective cohort study of bronchiectasis patients aged >15 years at three hospitals: Alice Springs Hospital and Monash Medical Centre in Australia, and Middlemore Hospital in New Zealand. Data included demographics, ethnicity, sputum microbiology, radiology, spirometry, hospitalization and survival over 5 years of follow-up. Results: Aboriginal Australians were significantly younger and died at a significantly younger age than other groups. Age- and sex-adjusted all-cause mortality was higher for Aboriginal Australians (hazard ratio (HR): 3.9), and respiratory-related mortality was higher for both Aboriginal Australians (HR: 4.3) and Māori and Pacific Islander people (HR: 1.7). Hospitalization was common: Aboriginal Australians had 2.9 admissions/person-year and 16.9 days in hospital/person-year. Despite Aboriginal Australians having poorer prognosis, calculation of the FACED score suggested milder disease in this group. Sputum microbiology varied with Aspergillus fumigatus more often isolated from non-indigenous patients. Airflow obstruction was common (66.9%) but not invariable. Conclusions: Bronchiectasis is not one disease. It has a significant impact on healthcare utilization and survival. Differences between populations are likely to relate to differing aetiologies and understanding the drivers of bronchiectasis in disadvantaged populations will be key.
- Subject
- bronchiectasis; hospitalization; premature mortality; Oceania; survival analysis
- Identifier
- http://hdl.handle.net/1959.13/1448370
- Identifier
- uon:43389
- Identifier
- ISSN:1323-7799
- Language
- eng
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