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

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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.

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