Introduction: Bronchiectasis (Br) is associated with diverse aetiologies. Inflammatory bowel disease (ulcerative colitis and Crohn's colitis) associated bronchiectasis (IBD-Br) is poorly described.
Objectives: Describe IBD-Br in specialist Br clinic. Compare to those with a coded diagnosis of IBD-Br seen in IBD clinics not referred to Br services.
Methods: A retrospective cohort study using clinic databases, electronic health records and primary care electronic health records. Patient demographics, characteristics including Bronchiectasis Severity Index (BSI) and clinic attended were recorded.
Results: 212 patients were identified from coding data, 55 (26%) were found to have documented evidence of IBD-Br. Of these, 28 (51%) were managed in Br services (Table1). Overall median age was 69 years, with 47% male and 53% female. Sputum microbiology showed H.influenzae most frequently isolated.
| IBD-Br attending Br clinic |
IBD-Br not referred |
P value | |
| Age | 70 |
68 |
0.846 |
| M:F ratio | 1:1 |
1:1.25 |
0.68 |
| Exacerbation frequency | 3 |
1.5 |
0.034 |
| % ?3 exacerbations recorded | 57 | 23 | 0.008 |
|
% lung function recorded |
93 | 63 | 0.007 |
| %FEV1 predicted where recorded | 83 | 76 | 0.785 |
| % positive sputum culture in last 3 yrs | 86 | 52 |
0.007 |
| % recorded physio input |
79 | 4 | <0.001 |
| BSI | 6.5 | 5 | 0.006 |
Conclusion: IBD-Br patients seen in bronchiectasis clinic are significantly more likely to have ?3 exacerbations per year, higher BSI, physio referral and chronic colonisation. However, 52% of those IBD-Br cases not referred to Br clinic had positive sputum cultures and 23% had ?3 exacerbations per year. We should be working closely with IBD services/guidelines to ensure that criteria for referral to Br clinic are followed to maximise patient care.