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https://hdl.handle.net/2440/133567
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Type: | Journal article |
Title: | Factors associated with "Frequent Exacerbator" phenotype in children with bronchiectasis: the first report on children from the Australian Bronchiectasis Registry |
Author: | Kapur, N. Stroil-Salama, E. Morgan, L. Yerkovich, S. Holmes-Liew, C.L. King, P. Middleton, P. Maguire, G. Smith, D. Thomson, R. McCallum, G. Owens, L. Chang, A.B. |
Citation: | Respiratory Medicine, 2021; 188:106627-1-106627-8 |
Publisher: | Elsevier BV |
Issue Date: | 2021 |
ISSN: | 0954-6111 1532-3064 |
Statement of Responsibility: | Nitin Kapur, Enna Stroil-Salama, Lucy Morgan, Stephanie Yerkovich, Chien-Li Holmes-Liew, Paul King, Peter Middleton, Graeme Maguire, Daniel Smith, Rachel Thomson, Gabrielle McCallum, Louisa Owens, Anne B Chang |
Abstract: | Introduction: In adults with bronchiectasis, multicentre data advanced the field including disease characterisation and derivation of phenotypes such as ‘frequent exacerbator (FE)’ (≥3 exacerbations/year). However, paediatric cohorts are largely limited to single centres and no scientifically derived phenotypes of paediatric bronchiectasis yet exists. Using paediatric data from the Australian Bronchiectasis Registry (ABR), we aimed to: (a) describe the clinical characteristics and compare Indigenous with non-Indigenous children, and (b) determine if a FE phenotype can be identified and if so, its associated factors. Methods: We retrieved data of children (aged <18-years) with radiologically confirmed bronchiectasis, enrolled between March 2016–March 2020. Results: Across five sites, 540 children [288 Indigenous; median age = 8-years (IQR 6–11)] were included. Baseline characteristics revealed past infection/idiopathic was the commonest (70%) underlying aetiology, most had cylindrical bronchiectasis and normal spirometry. Indigenous children (vs. non-Indigenous) had significantly more environmental tobacco smoke exposure (84% vs 32%, p < 0.0001) and lower birth weight (2797 g vs 3260 g, p < 0.0001). FE phenotype present in 162 (30%) children, was associated with being younger (OR(adjusted) = 0.85, 95%CI 0.81–0.90), more recent diagnosis of bronchiectasis (OR(adjusted) = 0.67; 95%CI 0.60–0.75), recent hospitalization (OR(adj) = 4.51; 95%CI 2.45–8.54) and Pseudomonas aeruginosa (PsA) infection (OR(adjusted) = 2.43; 95%CI 1.01–5.78). The FE phenotype were less likely to be Indigenous (OR(adjusted) = 0.14; 95%CI 0.03–0.65). Conclusion: Even within a single country, the characteristics of children with bronchiectasis differ among cohorts. A paediatric FE phenotype exists and is characterised by being younger with a more recent diagnosis, PsA infection and previous hospitalization. Prospective data to consolidate our findings characterising childhood bronchiectasis phenotypes are required. |
Keywords: | Bronchiectasis; children; registry; phenotypes; frequent exacerbator |
Rights: | © 2021 Published by Elsevier Ltd. |
DOI: | 10.1016/j.rmed.2021.106627 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/GNT1154302 |
Published version: | http://dx.doi.org/10.1016/j.rmed.2021.106627 |
Appears in Collections: | Medicine publications |
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