Etiology, Clinical Profile, and Exacerbation-Associated Factors Among Patients with Bronchiectasis Attending a Tertiary Care Hospital in Nepal: A Cross-Sectional Study

Abstract

Background: Bronchiectasis is a chronic respiratory disease characterized by irreversible bronchial dilatation, recurrent infections, and persistent airway inflammation, leading to substantial morbidity. In low- and middle-income countries, post-infectious etiologies remain predominant; however, data on the clinical profile and factors associated with disease exacerbations in Nepal are limited. This study aimed to evaluate the etiology, clinical and radiological characteristics, and exacerbation-associated factors among patients with bronchiectasis attending a tertiary care hospital in Nepal.

Methods: A hospital-based cross-sectional observational study was conducted among patients with bronchiectasis confirmed on high-resolution computed tomography of the chest. Sociodemographic variables, clinical features, comorbidities, past infectious history, and radiological findings were collected using a structured proforma. Exacerbation frequency was categorized and analyzed in relation to clinical, nutritional, and socio-economic factors. Data were analyzed using descriptive statistics, and associations were assessed using the chi-square test, with a p-value <0.05 considered statistically significant.

Results: A total of 180 patients were included, predominantly aged 60–80 years, with a slight female predominance. Post-infectious causes, particularly previous pulmonary tuberculosis and recurrent childhood respiratory infections, were the most common etiologies. Chronic cough, dyspnea, sputum production, chest pain, and hemoptysis were frequently reported. Multilobar disease was observed in most patients. Frequent exacerbations were significantly associated with low and middle socio-economic status (p<0.001) and abnormal body mass index, particularly underweight and overweight categories (p=0.037). No significant associations were observed with smoking status, alcohol use, dyspnea severity, or prior tuberculosis.

Conclusion: Bronchiectasis in Nepal predominantly affects older adults and is largely driven by post-infectious etiologies. Socio-economic status and nutritional factors are key determinants of exacerbation frequency, underscoring the importance of early diagnosis, nutritional optimization, and context-specific management strategies in resource-limited settings.