B107-07 Sex Differences in Bronchiectasis Outcomes in a National Cohort

Abstract Rationale Bronchiectasis is the third most common airways disorder, after asthma and COPD. Global incidence and prevalence is increasing and is highest amongst females over age 65 years. Bronchiectasis epidemiology and outcomes suggest white female predominance when relying on disease-specific registries from Western countries. Air pollution and particulate matter have been suggested to trigger bronchiectasis exacerbations; however, the impact of deployment-related airborne exposures from contemporary conflicts on pulmonary outcomes is just beginning to be characterized. We compared bronchiectasis prevalence and outcomes for Veterans across a national cohort. Methods We included Veterans engaged with primary care at any VA outpatient facility between fiscal years 16-23 who had ICD-10 codes for bronchiectasis (J47.9). Demographics, smoking history (never, ever, current), body mass index (BMI) at baseline and comorbidities were determined using established data sources. Self-identified race/ethnicity was categorized as white and non-white (combined black, Hispanic Asian/Pacific Islander, Native American, mixed, and unknown). We compared sex differences in smoking and comorbid conditions including alcohol use disorder, COPD, cancer and immunodeficiencies. Chronic severity of illness was measured using Charlson comorbidity Index (CCI) and categorized as 0-1 vs. 2 vs. 3 or more. Our primary outcome was 1-year mortality by sex using logistic regression and adjusting for relevant confounders. Results We identified 1186 female and 17,465 male patients diagnosed with bronchiectasis (Table 1). Females were diagnosed at a younger age when compared to men (mean 63.6 versus 72.7 years). Non-white race was reported for 31.5% of patients and was more common among female patients (41.1% vs. male=30.8%). CCI scores varied by sex with females having lower CCI scores (female 0-1=54.4%, 2=19.3%, 3 + =26.3%; male 0-1=34.3%, 2=18.1%, 3 + =47.5%). Among specific comorbidities of interest, COPD, bacterial pneumonia, alcohol use disorder and cancer were most common in both sexes. One-year mortality was 3.1% for females and 10.9% for males (p 0.0001). Conclusion Bronchiectasis-related characteristics and outcomes vary between female and male patients in a Veteran cohort. Substantial differences in age and race for patients with bronchiectasis were identified. Nested case control studies could inform how sex differences and exposures could affect bronchiectasis prevalence and outcomes. Future work will compare time-series to examine how toxic exposures could influence bronchiectasis in veterans. This abstract is funded by: VA healthcare system