Rates and Characteristics of Bronchiectasis-Related Hospitalizations in the United States in 2022: A Population-Based Cohort Study.

BACKGROUND

Bronchiectasis, a condition defined by radiographic evidence of abnormally widened airways, is increasing in prevalence. Previous studies have demonstrated increased morbidity and health care utilization among patients with bronchiectasis, but there is a dearth of recent data regarding the current rates and outcomes of persons hospitalized with bronchiectasis in the United States.

METHODS

A retrospective cohort analysis was performed of the 2022 HCUP National Inpatient Sample (NIS) dataset, focusing on persons admitted with bronchiectasis via ICD-10 codes. Demographic and clinical and cost characteristics were evaluated. Patients were classified as having bronchiectasis with asthma, chronic obstructive pulmonary disease, or none of these. Multivariable regression models with a priori covariates were constructed for outcomes of in hospital mortality, length of stay and cost. Sex-stratified analyses were also conducted. All analyses were run at a two-sided p value of 0.05 using R.

RESULTS

We identified 99,755 weighted hospitalizations (29.9 per 100,000), 57.6% female, median age 75 years. Admissions were highest among older females, but mortality was greater in males (adjusted OR 1.37, 95% CI 1.22-1.54) and in bronchiectasis-alone versus bronchiectasis-asthma (aOR 2.38, 95% CI 1.85-3.07). Most hospitalizations occurred in the Southwestern United States, but the Western United States region had the highest mortality and costs. Median cost was $58,582 and median length of stay was 5 days; respiratory failure occurred in 53.7% of admissions. Income and race were not independently associated with mortality.

CONCLUSIONS

Nearly 100,000 U.S. hospitalizations for bronchiectasis occurred in 2022, with the highest rates in older females but the greatest mortality in males and in bronchiectasis-alone phenotypes. Mortality remains substantial, particularly in these high-risk groups, underscoring the need for targeted prevention, earlier recognition, and phenotype-specific management strategies to curb the growing inpatient burden of bronchiectasis.