Heterogeneity of non-cystic-fibrosis bronchiectasis in multiethnic Singapore: A prospective cohort study at a tertiary pulmonology centre

Non-cystic fibrosis bronchiectasis (NCFB) is a highly heterogenous disease. We describethe clinical characteristics of NCFB patients and evaluate the performance of Bronchiectasis Severity Index(BSI) in predicting mortality.Methods: Patients attending the bronchiectasis clinic between August 2015 and April 2020 withradiologically proven bronchiectasis on computed tomography were recruited. Clinical characteristics,spirometry, radiology, microbiology and clinical course over a median period of 2.4 years is presented.Results: A total of 168 patients were enrolled in this prospective cohort study. They were predominantlywomen (67.8%), Chinese (87.5%) and never-smokers (76.9%). Median age of diagnosis was 64 years(interquartile range 56–71) and the most common aetiology was “idiopathic” bronchiectasis (44.6%).Thirty-nine percent had normal spirometries. Compared to female patients, there were more smokersamong the male patients (53.8% versus 8.5%, P<0.001) and a significantly larger proportion withpost-tuberculous bronchiectasis (37.0% vs 15.8%, P=0.002). Fifty-five percent of our cohort had a historyof haemoptysis. Lower body mass index, presence of chronic obstructive pulmonary disease, ever-smokerstatus, modified Reiff score, radiological severity and history of exacerbations were risk factors formortality. Survival was significantly shorter in patients with severe bronchiectasis (BSI>9) compared tothose with mild or moderate disease (BSI 9) compared tomild disease (BSI 0–4) was 14.8 (confidence interval 1.929–114.235, P=0.01).Conclusion: The NCFB cohort in Singapore has unique characteristics with sex differences. Overhalf the patients had a history of haemoptysis. The BSI score is a useful predictor of mortality inour population.Keywords: Bronchiectasis, exacerbations, gender, haemoptysis, mortality, Reiff score, sex