Survival Outcomes in US Medicare Patients with Non-Cystic Fibrosis Bronchiectasis by Rate of Baseline Exacerbations
Abstract Introduction There are limited real-world data on outcomes in patients with non-cystic fibrosis bronchiectasis (NCFBE). This study assessed clinical characteristics and survival in patients with NCFBE by baseline exacerbation rate. Methods Patients with bronchiectasis (≥ 1 inpatient or ≥ 2...
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2024-10-01
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| Series: | Pulmonary Therapy |
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| Online Access: | https://doi.org/10.1007/s41030-024-00275-x |
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| author | Joseph Feliciano Benjamin Lewing Maitreyee Mohanty Melanie Lauterio Sebastian Fucile Joseph Tkacz Alan F. Barker |
| author_facet | Joseph Feliciano Benjamin Lewing Maitreyee Mohanty Melanie Lauterio Sebastian Fucile Joseph Tkacz Alan F. Barker |
| author_sort | Joseph Feliciano |
| collection | DOAJ |
| description | Abstract Introduction There are limited real-world data on outcomes in patients with non-cystic fibrosis bronchiectasis (NCFBE). This study assessed clinical characteristics and survival in patients with NCFBE by baseline exacerbation rate. Methods Patients with bronchiectasis (≥ 1 inpatient or ≥ 2 outpatient claims with a bronchiectasis diagnosis code, or one outpatient claim with bronchiectasis code and a chest computed tomography scan) were from the 100% Medicare Fee-for-Service database (Jan 2014–Dec 2020). Patients had continuous enrollment ≥ 12 months pre-index (baseline) and post-index (follow-up), with index a random bronchiectasis claim preceded by ≥ 12 months bronchiectasis history. Patients with cystic fibrosis were excluded. Patients were stratified by exacerbations during baseline (0, 1, or ≥ 2). Follow-up exacerbation rate and all-cause mortality were assessed. Controls were identified using a multistep direct matching approach. Time to death from index was estimated by Kaplan–Meier analyses. Results Exacerbation analysis included 92,529 patients with NCFBE and 92,529 matched controls. Exacerbations were common (43% had ≥ 1 exacerbation), with patients with more baseline exacerbations more likely to have ≥ 2 exacerbations during follow-up (11.4%, 24.2%, and 46.8% of patients with 0, 1, and ≥ 2 baseline exacerbations, respectively). Survival analysis included 110,298 patients with NCFBE and 110,298 controls. Time to death was shorter in patients with more baseline exacerbations (P < 0.0001). Five-year survival was 55.3%, 62.6%, and 65.4% for patients with ≥ 2, 1, and 0 baseline exacerbations, respectively, compared with 64.1% for controls. Conclusions In these patients with NCFBE, exacerbations were common. History of exacerbations was associated with future exacerbations and increased all-cause mortality. |
| format | Article |
| id | doaj-art-d53106941e2f4014ad22377793b5ecac |
| institution | Kabale University |
| issn | 2364-1754 2364-1746 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Pulmonary Therapy |
| spelling | doaj-art-d53106941e2f4014ad22377793b5ecac2024-11-24T12:37:40ZengAdis, Springer HealthcarePulmonary Therapy2364-17542364-17462024-10-0110443945010.1007/s41030-024-00275-xSurvival Outcomes in US Medicare Patients with Non-Cystic Fibrosis Bronchiectasis by Rate of Baseline ExacerbationsJoseph Feliciano0Benjamin Lewing1Maitreyee Mohanty2Melanie Lauterio3Sebastian Fucile4Joseph Tkacz5Alan F. Barker6Insmed IncorporatedInovalonInsmed IncorporatedInsmed IncorporatedInsmed IncorporatedInovalonPulmonary and Critical Care, Oregon Health and Science UniversityAbstract Introduction There are limited real-world data on outcomes in patients with non-cystic fibrosis bronchiectasis (NCFBE). This study assessed clinical characteristics and survival in patients with NCFBE by baseline exacerbation rate. Methods Patients with bronchiectasis (≥ 1 inpatient or ≥ 2 outpatient claims with a bronchiectasis diagnosis code, or one outpatient claim with bronchiectasis code and a chest computed tomography scan) were from the 100% Medicare Fee-for-Service database (Jan 2014–Dec 2020). Patients had continuous enrollment ≥ 12 months pre-index (baseline) and post-index (follow-up), with index a random bronchiectasis claim preceded by ≥ 12 months bronchiectasis history. Patients with cystic fibrosis were excluded. Patients were stratified by exacerbations during baseline (0, 1, or ≥ 2). Follow-up exacerbation rate and all-cause mortality were assessed. Controls were identified using a multistep direct matching approach. Time to death from index was estimated by Kaplan–Meier analyses. Results Exacerbation analysis included 92,529 patients with NCFBE and 92,529 matched controls. Exacerbations were common (43% had ≥ 1 exacerbation), with patients with more baseline exacerbations more likely to have ≥ 2 exacerbations during follow-up (11.4%, 24.2%, and 46.8% of patients with 0, 1, and ≥ 2 baseline exacerbations, respectively). Survival analysis included 110,298 patients with NCFBE and 110,298 controls. Time to death was shorter in patients with more baseline exacerbations (P < 0.0001). Five-year survival was 55.3%, 62.6%, and 65.4% for patients with ≥ 2, 1, and 0 baseline exacerbations, respectively, compared with 64.1% for controls. Conclusions In these patients with NCFBE, exacerbations were common. History of exacerbations was associated with future exacerbations and increased all-cause mortality.https://doi.org/10.1007/s41030-024-00275-xClaims databaseExacerbationsMortalityNon-cystic fibrosis bronchiectasisSurvival |
| spellingShingle | Joseph Feliciano Benjamin Lewing Maitreyee Mohanty Melanie Lauterio Sebastian Fucile Joseph Tkacz Alan F. Barker Survival Outcomes in US Medicare Patients with Non-Cystic Fibrosis Bronchiectasis by Rate of Baseline Exacerbations Pulmonary Therapy Claims database Exacerbations Mortality Non-cystic fibrosis bronchiectasis Survival |
| title | Survival Outcomes in US Medicare Patients with Non-Cystic Fibrosis Bronchiectasis by Rate of Baseline Exacerbations |
| title_full | Survival Outcomes in US Medicare Patients with Non-Cystic Fibrosis Bronchiectasis by Rate of Baseline Exacerbations |
| title_fullStr | Survival Outcomes in US Medicare Patients with Non-Cystic Fibrosis Bronchiectasis by Rate of Baseline Exacerbations |
| title_full_unstemmed | Survival Outcomes in US Medicare Patients with Non-Cystic Fibrosis Bronchiectasis by Rate of Baseline Exacerbations |
| title_short | Survival Outcomes in US Medicare Patients with Non-Cystic Fibrosis Bronchiectasis by Rate of Baseline Exacerbations |
| title_sort | survival outcomes in us medicare patients with non cystic fibrosis bronchiectasis by rate of baseline exacerbations |
| topic | Claims database Exacerbations Mortality Non-cystic fibrosis bronchiectasis Survival |
| url | https://doi.org/10.1007/s41030-024-00275-x |
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