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Socioeconomic deprivation, readmissions, mortality, and acute exacerbations of bronchiectasis.
MedLine Citation:
PMID:  21299784     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aims: Bronchiectasis is known to cause significant morbidity in children in New Zealand. Little is known of the disease in adults. Our objective was to characterize a cohort of adults who presented to hospital with acute exacerbations of the disease. Methods: We retrospectively collected information on all exacerbations treated as in-patients from a single hospital in South Auckland, New Zealand during 2002. Results: We collected information on 307 exacerbations in 152 patients. Twenty seven percent were of Maaori ethnic origin, and 44% Pacific. Seventy percent lived in areas categorized as the 20% most deprived in New Zealand. Comorbid conditions were present in 80% of patients - most commonly COPD, asthma, diabetes and cardiac disease. Seventy (46%) patients had at least one readmission and thirty-two patients (21%) died within 12 months of admission to hospital. Greater deprivation was associated with increased mortality at 12 months after admission after adjusting for other factors (OR 11, 95% CI 2.0- 61, p = 0.006). In the subgroup who underwent high-resolution CT scanning (93), increasing severity of bronchiectasis (modified Bhalla score) was associated with readmission within 12 months (p = 0.004), but not mortality (p = 0.419). Conclusions: We have shown that exacerbations of bronchiectasis in South Auckland are more common in patients who are predominantly of Maaori or Pacific descent and are socioeconomically deprived. Admission to hospital for an exacerbation is associated with high readmission and mortality rates.
Authors:
Mark E Roberts; Lucy Lowndes; David G Milne; Conroy A Wong
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-8
Journal Detail:
Title:  Internal medicine journal     Volume:  -     ISSN:  1445-5994     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101092952     Medline TA:  Intern Med J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Sydney South West Area Health Service. Journal compilation © 2011 Royal Australasian College of Physicians.
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