台灣支氣管擴張症相關疾病之住院趨勢分析

Trends and Burden of Bronchiectasis-Associated Hospitalizations in Taiwan, 1998-2008

目的：支氣管擴張症（bronchiectasis），是由於主支氣管反覆感染和發炎而造成支氣管異常，而且是不可回復的擴張和破壞，導致成為慢性呼吸道疾病，並可能併發其他呼吸道疾病導致住院及死亡，因此本研究期能分析支氣管擴張症及相關疾病住院病患，在台灣的特性與趨勢。方法：運用1998年至2008年全民健康保險資料庫，以住院醫療費用清單明細檔為主，取得住院資料主次診斷之疾病分類碼中含有支氣管擴張症，即ICD-9-CM碼為494者。結果：整體平均每年男性約在每10萬人約有15人次，女性則有每10萬人20人次的住院次數。支氣管擴張症傳統上有女性及年長者有較高的趨勢，不過在趨勢上住院率有緩和下降的趨勢。結論：台灣支氣管擴張症的住院率分析，性別年齡的趨勢與歐美國家趨勢一致，女性及高齡者有較高的住院比率。但在住院率的數值來看，台灣支氣管擴張症相關疾病的住院率仍高於美國，且在診斷碼分類為支氣管擴張症相關疾病患者中，有較高比率主診斷即被歸為支氣管擴張症，其原因值得吾人關注與進一步的分析研究。

Objectives. Bronchiectasis is an inflammatory disease that is caused by the destruction of muscle and elastic tissue, which leads to infection or irreversible dilation of part of the bronchial tree, and may result in chronic airflow obstruction and impaired clearance of secretions. Bronchiectasis is associated with a wide range of disorders. The purpose of this study was to analyze the characteristics and trends of bronchiectasis and its related admission rates in Taiwan. Methods. This study is based on data obtained from the National Health Insurance Research Database (NHIRD) for the years of 1998-2008. Data was extracted from admission data of patients diagnosed with bronchiectasis for either primary or the secondary diagnosis (ICD-9-CM code 494). Results. Results indicated that the overall average rate of bronchiectasis-associated hospitalizations (B-AH) was approximately 15 person-times per 100,000 in male patients and 20 person-times per 100,000 female patients. Although current rates of hospitalization for bronchiectasis are higher among women and the elderly, this trend seems to be gradually declining. Conclusions. Our analysis of bronchiectasis hospitalization rate trends in Taiwan according to gender and age was consistent with those of Europe and the United States of America. Females and the elderly have higher admission rates than those of other patient groups. Admission rates of bronchiectasis-related diseases among Taiwanese of both genders and all age groups were still higher than those in the U.S.A. Moreover, when comparing diagnosis rates of bronchiectasis-related diseases in Taiwan to those of Europe and the U.S., we found Taiwan to have a higher rate of bronchiectasis as the primary diagnosis. These divergences are worthy of further attention and study.