Factors associated with “Frequent Exacerbator” phenotype in children with bronchiectasis: The first report on children from the Australian Bronchiectasis Registry - 23/10/21
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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 (ORadjusted = 0.85, 95%CI 0.81–0.90), more recent diagnosis of bronchiectasis (ORadjusted = 0.67; 95%CI 0.60–0.75), recent hospitalization (ORadj = 4.51; 95%CI 2.45–8.54) and Pseudomonas aeruginosa (PsA) infection (ORadjusted = 2.43; 95%CI 1.01–5.78). The FE phenotype were less likely to be Indigenous (ORadjusted = 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.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Bronchiectasis in children is an important yet heterogenous chronic respiratory condition with significant knowledge gaps. |
• | This is the largest multi-centric study defining clinical phenotypes using a registry-based approach. |
• | A Frequent Exacerbator phenotype exists in children with bronchiectasis.. |
Keywords : Bronchiectasis, Children, Registry, Phenotypes, Frequent exacerbator
Plan
☆ | Grant support: None for the study. The ABR is an initiative of the Lung Foundation of Australia. AC is supported by a National Health and Medical Research Council senior practitioner fellowship (grant APP1154302). |
Vol 188
Article 106627- novembre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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