TOPLINE:

Hospitalizations for exacerbations of bronchiectasis were associated with a higher mortality rate, longer hospital stays, and higher costs than those for exacerbations of chronic obstructive pulmonary disease (COPD) or asthma.

METHODOLOGY:

• Researchers analyzed a US national database to compare outcomes of hospitalizations for bronchiectasis exacerbations with those for COPD and asthma exacerbations among adults hospitalized between 2017 and 2021.
• Patients were divided into three groups:
  • Those with bronchiectasis exacerbations with or without overlapping COPD or asthma exacerbations (n = 232,825; median age, 72 years; 58.9% female)
  • Those with COPD exacerbations (n = 8,403,302; median age, 70 years; 53.3% female)
  • Those with asthma exacerbations (n = 1,278,839; median age, 56 years; 71% female)
• They also assessed the association between the COVID pandemic (2020-2021) and the incidence and outcomes of hospitalizations for exacerbations of these three airway diseases.

TAKEAWAY:

• The bronchiectasis group had a significantly longer median length of hospital stay (5 days) than the COPD (4 days) or asthma (3 days) groups (P < .0001 for both).
• The bronchiectasis group also incurred significantly higher median hospital costs ($50,393) than the COPD ($38,040) or asthma ($31,262) groups (P < .0001 for both).
• Hospitalized patients with bronchiectasis exacerbations were 1.2 times more likely to die than those with COPD exacerbations and three times more likely than those with asthma exacerbations (P < .0001 for both).
• During the COVID pandemic, the rate of hospitalizations fell by just 8% for bronchiectasis exacerbations vs 26% for COPD exacerbations and 28% for asthma exacerbations, and the mortality rate for the bronchiectasis group increased from about 4.3% pre-pandemic to 9.3% in 2021.

IN PRACTICE:

“[Our] findings highlight the need for more targeted management strategies and increased awareness of bronchiectasis to improve patient outcomes and further reduce healthcare burdens,” the authors of the study wrote.

SOURCE:

The study was led by Mohamad El Labban, MD, Mayo Clinic Health System, Mankato, Minnesota. It was published online on November 10, 2025, in ERJ Open Research.

LIMITATIONS:

The national database records hospital encounters rather than individual patients, potentially overrepresenting those with recurrent admissions. The reliance on administrative codes may have affected data accuracy, and differences in facilities’ billing practices could have introduced discrepancies in hospitalization cost estimates. Additionally, the COVID pandemic may have biased results by disproportionately affecting certain groups.

DISCLOSURES:

The study received no financial support. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.