Non-Cystic Fibrosis Bronchiectasis in the United States: Prevalence Trends in a Large Electronic Health Record Population, 2015-2025.

Abstract

Despite growing clinical awareness of bronchiectasis, contemporary estimates of its burden in the general United States population are lacking. What are the trends in prevalence of non-cystic fibrosis bronchiectasis in a US primary care population from 2015-2025, and how does prevalence vary by demographic characteristics and subspecialist evaluation? We conducted a retrospective, repeated cross-sectional population analysis using the Epic Cosmos electronic health record database encompassing over 307 million de-identified patients across the US. Adults aged ≥18 years with at least one visit to an internal medicine, family medicine, geriatrics, or gynecology provider between 2015 and 2025 formed the primary care (PC) population. Bronchiectasis (excluding cystic fibrosis) was identified by ICD-10 and CPT codes requiring a discharge diagnosis, two clinic visits with a billed diagnosis, or one visit with a billed diagnosis preceded by a chest CT. We calculated annual age-adjusted prevalence rates with 95% confidence intervals and performed multivariable regression. In 2025, the PC population included over 58 million patients. There were 191,203 individuals who met the bronchiectasis case definition, yielding an age-adjusted prevalence of 270.3 (95% CI, 267.2-273.5) per 100,000 patients. Prevalence increased 133% from 2015 to 2025. Patients with case-defined bronchiectasis were older (average age 72.1 vs 58.1), more often female (66% vs 60%), more likely to identify as white (75.3% vs 63.8%), less likely to identify as Hispanic or Latino (5% vs 9%), and more likely to have Medicare coverage (61.4% vs 23.5%) than the PC population.