Introduction: Pulmonary hypertension (PH) can be a risk factor for the disease severity and affect the prognosis of patients with bronchiectasis.

Aims: To evaluate the association between PH and hospital admission rates in patients with bronchiectasis.

Methods: We performed a retrospective analysis of 641 patients diagnosed with bronchiectasis at National Medical Center, Korea, from November 2012 to October 2022. HRCT and echocardiographic assessment were used to evaluate PH. Patients were divided into two groups according to hospital admission. Logistic regression analysis was performed to identify the risk factors associated with hospital admission rates.

Results: Of 130 patients (67±11 years, 53% male), 32 (25%) patients had suspected PH on echocardiography. In baseline characteristics, the Admission group (N=69) had a higher baseline mMRC dyspnea scale, more hemoptysis events, diseased lung lobes and decreased lung function (p<0.05) compared to the non-Admission group (N=61). In univariate analysis, the Admission group showed an increase in main pulmonary artery (mPA) diameter, PA (mPA to Aorta) ratio, involvement of lung lobes, cavities and nodules, and increased systolic pulmonary artery pressure and peak Tricuspid Regurgitation velocity (p<0.05). In multivariate analysis, increased mPA diameter (adjusted OR 1.1, 95% CI 1.0-1.2) and involvement of more than two lobes (adjusted OR 3.35, 95% CI 1.3-8.8) were significant risk factors for hospital admission.

Conclusion: In addition to lung parenchymal involvement in HRCT, increased mPA diameter to assess PH was an independent risk factor for hospital admission in patients with bronchiectasis