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July 14, 2026Open Access

Age-related differences in clinical outcomes and lung function trajectories in noncystic fibrosis bronchiectasis: a multicenter TBARC registry study

WCWen‐Chien ChengNational Chung Hsing University CCChia‐Ling ChangNational Taiwan University CSChau‐Chyun SheuKaohsiung Medical University

Key Points

This study aims to investigate age-related differences in clinical outcomes and lung function trajectories in patients with non-cystic fibrosis bronchiectasis.
Retrospective cohort study using data from the Taiwan Bronchiectasis Research Collaboration registry.
Stratified adult patients into three age groups: < 50 years, 50–69 years, and ≥ 70 years.
Compared acute exacerbations, hospitalizations, survival rates, and lung function changes across age groups.
Increasing age correlated with higher comorbidity burden and poorer lung function.
Younger patients (< 50 years) had a higher risk of recurrent hospitalization despite better baseline function.
Greatest lung function decline observed in younger patients, while older groups maintained stable lung function.

Abstract

Bronchiectasis is commonly considered a disease of older adults, with advancing age associated with greater disease severity and poorer clinical outcomes. However, whether younger patients represent a genuinely low-risk phenotype characterized by fewer exacerbations, reduced hospitalization burden, preserved lung function, and lower mortality risk remains uncertain. We conducted a retrospective cohort study using data from the Taiwan Bronchiectasis Research Collaboration, a nationwide multicenter registry. Adult patients with non-cystic fibrosis bronchiectasis were stratified according to age at enrollment into three groups: < 50 years, 50–69 years, and ≥ 70 years. Acute exacerbations, hospitalizations, overall survival, and longitudinal changes in pulmonary function were compared among the age groups. Among 2753 patients, increasing age was associated with a higher comorbidity burden, poorer baseline lung function, and lower overall survival. Although most patients across all age groups did not experience exacerbations, the proportion of frequent exacerbators requiring hospitalization (≥ 2 hospitalizations per year) was comparable between patients aged < 50 years and those aged ≥ 70 years. Compared with patients aged 50–69 years, those aged < 50 years had a significantly higher risk of recurrent hospitalization. Longitudinal analyses demonstrated the greatest absolute declines in pre-bronchodilator forced expiratory volume in 1 s and forced vital capacity among patients aged < 50 years, with a trend toward greater FEV 1 decline, whereas lung function remained relatively stable in the older age groups. In this nationwide cohort, younger patients exhibited clinically meaningful disease activity, including recurrent hospitalization and greater longitudinal lung function decline, despite fewer comorbidities and better baseline lung function. These findings underscore the heterogeneity of bronchiectasis and suggest that younger age does not necessarily indicate a benign disease course.

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