Global Epidemiology and Impact of Bronchiectasis in Adults without Cystic Fibrosis

The incidence and prevalence of bronchiectasis have increased over recent years, and it is no longer considered a rare or orphan disease. Most data on bronchiectasis incidence and prevalence comes from higher income countries across Asia, Europe, and North America, but there are ongoing efforts to systematically identify and evaluate bronchiectasis in other regions. Bronchiectasis incidence and prevalence increase with age and is generally more common in females. Bronchiectasis is a heterogeneous disease, and etiology is broadly assessed as post-infectious, associated with pulmonary (e.g., chronic obstructive pulmonary disease [COPD] or pulmonary ciliary dyskinesia) or other underlying diseases, but most frequently idiopathic with unknown etiology. Consistently around half of older adults with a bronchiectasis diagnosis also have a COPD diagnosis. The frequency of chronic infections at diagnosis and during follow-up varies globally. Common pathogens that require attention include Pseudomonas aeruginosa, Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, Aspergillus species, and less commonly nontuberculous mycobacteria. Hospitalization rates are low but associated with a significant cost. Mortality rates are higher in those with bronchiectasis than in age-matched populations, but most patients with bronchiectasis die of other causes.