The Impact of GERD on the Risk of Incident Bronchiectasis: A Nationwide Representative Population-Based Study in Korea.

Background/Aims The close association between gastroesophageal reflux disease (GERD) and chronic respiratory diseases has been suggested. However, limited information is available on whether GERD is associated with an increased incidence of bronchiectasis. Methods Using a nationwide representative claim-based database, we identified adults with GERD (GERD cohort) and their propensity score matched controls without GERD (matched controls) between 2004 and 2012. Both cohorts were follow-up until the date of bronchiectasis diagnosis, date of death, or Dec 2015. Cox proportional hazard regression analyses were used to evaluate the risk of bronchiectasis between the groups. Using the GERD cohort, we also evaluated factors associated with bronchiectasis. Results During the median follow-up of 9.5 years (interquartile range: 6.33–12.17 years), the cumulative incidence of bronchiectasis was significantly higher in the GERD cohort than in matched controls (418.59 person-years vs. 291.68 person-years; p<0.01) with a hazard ratio of 1.43 (95% confidence interval=1.13–1.55). Among the GERD cohort, factors associated with an increased risk of developing bronchiectasis were an increase in age (the highest adjusted hazard ratio [aHR]= 8.56, 95% confidence interval [CI]= 4.88–15.03) for those aged 70 years or older), underweight (aHR=1.76, 95% CI=1.33–2.54), chronic obstructive pulmonary disease (aHR=1.32, 95% CI=1.06–1.65), asthma (aHR=1.50, 95% CI=1.25–1.80), and peptic ulcer disease (aHR=1.24, 95% CI=1.08–1.42) Conclusion GERD is associated with an increased risk of bronchiectasis. Age, underweight, coexisting airway diseases, and peptic ulcer disease were risk factors for developing bronchiectasis in GERD. [ABSTRACT FROM AUTHOR]