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SYSTEMATIC REVIEW
Aetiology of bronchiectasis in adults: A systematic literature review
YONG-HUA GAO,1‡ WEI-JIE GUAN,2‡ SHAO-XIA LIU,1 LEI WANG,1 JUAN-JUAN CUI,1 RONG-CHANG CHEN2§ AND
GUO-JUN ZHANG1§
1
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou and 2State
Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory
Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
ABSTRACT
While identifying the underlying aetiology is a key part
of bronchiectasis management, the prevalence and
impact of identifying the aetiologies on clinical
management remain unclear. We aimed to determine
the etiological spectrum of bronchiectasis, and how
often etiological assessment could lead to the changes
in patients’ management. A comprehensive search was
conducted using MEDLINE (via PubMed) and EMBASE
for observational studies published before October
2015 reporting aetiologies in adults with bronchiectasis.
Of the 8216 citations identified, 56 studies including
8608 adults with bronchiectasis were relevant for this
systematic review. The crude prevalence for the
identified aetiologies ranged from 18% to 95%, which
possibly resulted from the differences in the geographic
regions and diagnostic workup. Post-infective (29.9%),
immunodeficiency (5%), chronic obstructive pulmo-
nary disease (3.9%), connective tissue disease (3.8%),
ciliary dysfunction (2.5%), allergic bronchopulmonary
aspergillosis (2.6%) were the most common aetiologies.
In 1577 patients (18.3%), identifying the aetiologies led
to changes in patient’s management. Aetiologies varied
considerably among different geographic regions
(P < 0.001). Intensive investigations of these aetiologies
might help change patient’s management and therefore
should be incorporated into routine clinical practice.
Key words: adult, aetiology, bronchiectasis, management,
systematic review.
Abbreviations: ABPA, allergic bronchopulmonary aspergillosis;
COPD, chronic obstructive pulmonary disease; CTD, connective
tissue disease.
Correspondence: Guo-jun Zhang, Department of Respiratory and
Critical Care Medicine, The First Affiliated Hospital of Zhengzhou
University, 1 Jianshe East Road, Zhengzhou, Henan 450052,
China. Email: zhanggj1966@sina.com
‡ §
Y. H. G. and W. J. G., and R. C.C. and G. J. Z. have contributed
equally to this study.
Received 22 December 2015; invited to revise 4 March and 22
March 2016; revised 16 and 22 March 2016; accepted
24 March 2016 (Associate Editor: Conroy Wong).
© 2016 Asian Pacific Society of Respirology
INTRODUCTION
Non-cystic fibrosis bronchiectasis (hereafter referred
to as bronchiectasis) is a heterogeneous airway disease
characterized by chronic cough, sputum production
and recurrent exacerbations which lead to increased
morbidity and worsened quality of life.1 Mounting
evidence indicates that a wide range of disorders could
cause bronchiectasis.2 Given that the identification of
underlying causes may lead to a change in patient’s
management, which then would translate into better
prognosis, a systematic etiologic evaluation of
bronchiectasis is deemed clinically reasonable and
pivotal.
Recently, several studies have prospectively inves-
tigated the aetiology of bronchiectasis in adults.3–5
However, there were significant discrepancies in the
results. A multicentre cohort study of 1258 bron-
chiectasis patients showed that idiopathic bron-
chiectasis accounted for 40% of patients,5 followed by
post-infective (20%), chronic obstructive pulmonary
disease (COPD) (15%), connective tissue disease (CTD)
(10%), immunodeficiency (5.8%) and asthma (3.3%),
which led to changes in 13% of patient’s management;
whereas a study from the USA reported that only 7%
of bronchiectasis patients were idiopathic,6 followed
by autoimmune disease (31.1%), immunodeficiency
(17%), hematologic malignancy (14.2%), aspiration
(11.3%) and α1-antitrypsin deficiency (11.3%).
Additionally, our research group previously reported
that the most common aetiologies were idiopathic
(46.0%),3 post-infective (27.0%) and immunodeficiency
(8.8%), which corresponded to a change of
management in 19.7% of the patients. The exact
explanations accounting for these disparities remain
unclear but may be multifaceted, including the
difference in study design, ethnicity and sample size.
Although it has been long held that the permanent
bronchial dilatation in patients with bronchiectasis
could not be readily cured by any means of medication,
certain aetiologies (i.e. immunodeficiency and
α1-antitrypsin deficiency) might respond preferentially
to the targeted therapy (e.g. supplementation of
immunoglobin). More importantly, our perception of
the etiologic spectra of bronchiectasis has been largely
based on the literature reports that focused on a specific
Respirology (2016)
doi: 10.1111/resp.12832
2 Y-H Gao et al.
geographic region, which frequently yielded conflicting
findings. Therefore, an updated, comprehensive
understanding of the prevalence of bronchiectasis
aetiologies and their geographic differences, and how
the extent of identified causes might modify the disease
course are crucial for providing best care and would
ultimately improve the prognosis of bronchiectasis
patients.
In this systematic review, we sought to (i) evaluate
the prevalence of specific aetiologies; (ii) determine
how often such etiological identification could result
in a change in patient’s management; and (iii)
compare the etiologic differences across different
geographic regions.
METHODS
Data sources and searches
The literature search was performed to identify
publications reporting the etiologies among adults
with bronchiectasis from observational data,
published in English prior to October 21st 2015. The
methods used to perform this review involved both
electronic and manual components, and followed
established "best practice" guidelines for systematic
review research.7,8 Searches were conducted in the
MEDLINE (via PubMed) and EMBASE databases to
identify relevant studies on the target population
published from January 1, 1966 to October 21, 2015.
Key terms included ‘etiology’ or ‘aetiology’ or
‘causality’ or ‘causes’ and ‘bronchiectasis’ or ‘non-
cystic bronchiectasis’ or ‘non-CF bronchiectasis’ or
‘NCFB’. The electronic searches were supplemented
by manual screening of the reference lists of all
accepted articles.
Study selection
Study selection was accomplished through two levels
of study screening with pre-specified inclusion and
exclusion criteria. During screening of each title and
abstract, all papers were reviewed by two independent
researchers (Y. H. G. and W. J. G.) with the
disagreement arbitrated by the principal investigator
(G. J. Z.). At Level I screening, any study that met an
exclusion criterion was rejected. Exclusion criteria
included the following: (i) wrong study type
(interventional studies, expert opinions, systematic
reviews and meta-analyses; (ii) studies published in a
language other than English; (iii) no bronchiectasis
patients; and (iv) cystic fibrosis-related bronchiectasis.
Level II screening included a review of the full-text
articles of those selected from Level I. To pass Level II
screening and be included in this review, studies must
be observational with prospective, retrospective, case-
control or cross-sectional design or a reanalysis of
clinical trials data where the study intervention did
not figure in the analysis, and data could be extracted
from the studies (at least included the number or
percentage of major aetiologies). The method for
definitions of bronchiectasis aetiology was based on
the reported data in the respective studies.
Respirology (2016)
Patient overlap between studies is likely to exist,
because most studies on bronchiectasis are
performed in a limited number of centres. When
the aetiologies were reported more than once by
the same centre with overlapping inclusion periods,
only the largest studies were included. In the case
of exactly matching patient numbers, the most
recent study was included.
Data extraction
Data of interest from each included studies were
extracted, which consisted of the study-level (i.e. year
of publication, study location, study design and
population) and patient-level characteristics (i.e.
sample size, mean age, gender distribution and
prevalence estimates). Because our primary goal was
to identify the prevalence of specific aetiologies in
adults with bronchiectasis, only observational studies
were selected for final analysis.
Data synthesis and analysis
Because of the presence of substantial heterogeneity
across the studies (design, population, sample size,
inclusion criteria, diagnostic workup and definition of
individual aetiology), a meta-analysis was not per-
formed, and a qualitative description was presented.
Study and patient characteristics were presented by
descriptive statistics such as means, medians, standard
deviations and ranges. The categorical aetiologies of
bronchiectasis were pooled to provide the estimates
of the relative prevalence for individual aetiology. The
total sample size estimates for categorical comparisons
were calculated from the total number of aetiologies
identified for the entire review. The chi-square or
Fisher’s exact test was used to compare the unique
etiologic spectra among different regions when
appropriate.
RESULTS
Study attrition
Literature search via PUBMED and EMBASE
databases yielded a total of 8216 abstracts or
articles. In total, 1709 duplicates were removed,
and 6507 abstracts or articles were screened for
eligibility. Upon further review, 6201 abstracts or
articles were rejected for meeting the study
exclusion criteria (design not an observational
study or no non-cystic fibrosis bronchiectasis
patients enrolled). Of the 306 full-text articles
reviewed at Level II screening, 54 reported on
aetiologies of bronchiectasis.3–6,9–58 The reference
lists of included studies were manually reviewed
for identification of relevant articles that were not
identified from the initial search. From the manual
review, two additional full-text articles were
included.59,60At last, 56 articles were included for
final analysis (Fig. 1).3–6,9–60
© 2016 Asian Pacific Society of Respirology
Aetiology in bronchiectasis
Study characteristics
As shown in Table S1 in the Supplementary Information,
24 studies (42.9%) analysed were prospective
cohort studies3–6,9,10,13,14,16,23,32,36–38,43,44,46,49–52,54,60;
19 (33.9%) were retrospective cohort
studies11,12,17,20,22,24,25,27,30,31,34,39,41,42,53,55,58,59; 7 (12.5%)
were case-control studies15,19,28,33,48,56,57 and six
(10.7%) were cross-sectional.18,21,26,35,45,47 The number
of bronchiectasis patients ranged from 20 to 1258,
and the mean age ranged from 42 to 73 years. Most
studies (n = 45; 80.4%) reported patient samples
composed of more than 50% women, although the
gender ratio was not specified in all studies. The
prevalence of the identified aetiologies ranged from
18% to 95%. Geographically, 62.5% of aetiologies
(n = 35) were reported in studies conducted
in Europe,5,9–11,16,21–25,27–34,37,38,40,42–45,49,51–55,57–60
14.3% (n = 8) in Asia,3,4,12,13,15,48,50,56 six in Oceania
(Australia),14,36,39,41,46,47 five in South America
(Brazil),17–19,26,35 one in North America (USA)6 and
one in Africa (Tunisia).20
The underlying causes associated with bronchiectasis
in adults are summarized in Table S2 in the
Supplementary Information. With the inclusion of
these studies, the total number of aetiologies (8656)
exceeds the total number of patients reported (8608).
Three studies have reported multiple aetiologies for
individual patients. Our group from China (n = 146)
found that three patients had dual aetiologies.3 Another
study from the USA (n = 106) reported that 13 patients
(13.3%) had dual aetiologies and three patients (2.8%)
had triple aetiologies.6 In a retrospective study
including 539 patients, Goeminne and colleagues at
Belgium reported that 22 patients have dual possible
underlying causes of bronchiectasis in Belgium.27
© 2016 Asian Pacific Society of Respirology
3
Figure 1 A flow chart showing the
procedure for identifying the studies
included in the systematic review.
Synthesis of bronchiectasis aetiologies
Among the included study population, the idiopathic
aetiology of bronchiectasis was found in 44.8% of
patients (range: 5–82%). Following exclusion of
idiopathic bronchiectasis, the six most common known
aetiologies were post-infective (29.9%), immunode-
ficiency (5%), COPD (3.9%), CTD (3.8%), ciliary
dysfunction (2.5%) and allergic bronchopulmonary
aspergillosis (ABPA) (2.6%), Table 1.
Among all identified aetiologies of bronchiectasis, at
least one aetiology that had the potential to change
patient’s treatment or requiring genetic screening was
identified in 1577 patients (18.3%). Of these underlying
causes, 429 were attributable to immunodeficiency,
328 to CTD, 223 to ABPA, 120 to asthma, 66 to
inflammatory bowel disease, 64 to aspiration, 46 to
non-tuberculosis mycobacterium and 27 to panbron-
chiolitis; 218 cases with ciliary dysfunction and 36 cases
with α1-antitrypsin deficiency were identified that
prompted clinicians to directed therapy or undertake
familial screening.
Bronchiectasis aetiologies according to geographic
regions
Among all eligible studies, 35 were from Europe, 8 from
Asia, 6 from Oceania, 5 from South America, 1 from
North America and 1 from Africa. Aetiology of
bronchiectasis according to geographic location is
delineated in Table 2.
Overall, aetiologies among these cohorts are
significantly different because of the different patient
populations assessed, the number of available studies
included, the eligibility criteria and the diagnostic
Respirology (2016)
4 Y-H Gao et al.

Table 1 Summary of the risk factors for development of significant impact on patient’s management. To our
bronchiectasis in adults by disease category (n = 8608 knowledge, this systematic review presented the very
patients) first summary of literature related to the prevalence
of specific aetiologies among adults with
Risk factors Total number % of total bronchiectasis. Overall, at least one underlying cause
of bronchiectasis can be identified in 55.2% of 8608
Idiopathic bronchiectasis 3857 44.8
patients. The identification of underlying causes may
Post-infective bronchiectasis 2574 29.9
lead to a change in the management of 18.3% patient.
Immunodeficiency 429 5.0
Post-infective, immunodeficiency, COPD, CTD, ciliary
Chronic obstructive pulmonary 333 3.9
dysfunction and ABPA were the most common known
disease
aetiologies, although the estimates varied widely
Connective tissue disease 328 3.8
depending on the source population.
Allergic bronchopulmonary 223 2.6
Our study showed that the underlying causes could
aspergillosis
not be identified in nearly half of patients (44.8%),
Ciliary dysfunction 218 2.5
which underscore the basic and translational research
Asthma 120 1.4
to better understand pathophysiological mechanisms
Inflammatory bowel disease 66 0.8
leading to bronchiectasis in these patients. Admittedly,
Obstructive 67 0.8
the definition of idiopathic bronchiectasis has been a
Aspiration/esophageal reflux 64 0.7
major challenge in clinical practice, and there is
Congenital malformation 33 0.4
regrettable no accepted gold criteria. It is still likely that
α1-Antitrypsin deficiency 36 0.4
more intensive assessment would lead to the
Diffuse panbronchiolitis 27 0.3
identification of other known aetiologies in patients
Pink’s disease 20 0.2
with idiopathic bronchiectasis; hence, this diagnostic
Yellow nail syndrome 11 0.1
label should be interpreted with caution. Of known
Others† 250 2.9
aetiologies, post-infective was the most frequent
†
Other aetiologies including sinobronchial syndrome (n = 27), (29.9%), of which post-tuberculosis was the
amyloid (n = 1), smoke inhalation (n = 1), eosinophilic bronchiolitis predominant category, which contrasted to the
(n = 1), Young’s syndrome (n = 26), bronchiolitis obliterans etiologic spectra in children where bacterial and viral
(n = 3), vasculitis (n = 5), interstitial lung disease (n = 63), cystic pneumonia were the main causes.61 In fact, the
fibrosis or cystic fibrosis transmembrane conductance regulator genuine association between prior infections and the
related bronchiectasis (n = 20), systematic disease (n = 47) and occurrence of bronchiectasis remains largely elusive
other unreported (n = 42). in clinical practice, partly because of the inherent
difficulty in determining the temporal associations,
the severity of prior infection, the lack of gold criteria
for defining post-infective bronchiectasis and patients’
workup to define the specific aetiologies. For instance, recall bias. Nonetheless, our findings indicated that
COPD and asthma were initially excluded in some post-infective bronchiectasis remains a major category
studies during recruitment,4,37 although recent studies in developing and developed countries. Additionally,
have shown that 29–69% of COPD patients show post-TB bronchiectasis in Asian was more common
evidence of bronchiectasis on chest CT scans and than that in Europe, which could be explained by the
bronchiectasis has been listed as the seventh leading higher prevalence of TB in Eastern countries,62 and
comorbidity in COPD. Additionally, panbronchiolitis highlighted TB is still an important risk factor for
was largely distributed to Oriental Asia. Notably, there development of bronchiectasis in Asian.
was a significantly higher prevalence of idiopathic The second most prevalent cause of bronchiectasis
bronchiectasis in Asia and Oceania (59.2% and 67%, in our systematic review was COPD, although COPD
respectively) when compared with Europe (41.1%), has been listed as the major exclusion criteria in many
South America (37.3%), Africa (25%) and North studies.4,6,37 In fact, recent studies have reported that
America (6.6%), respectively (P < 0.001). However, 29–69% of patients with COPD might have evidence
relevant studies were extremely scarce in the literature of concomitant bronchiectasis on high-resolution
from Africa (n = 1) and North America (n = 1), which computed tomography scans, and patients with COPD
limits the direct comparisons of these cohorts. who had concomitant bronchiectasis (COPD-
Of post-infective bronchiectasis, 29 studies presented bronchiectasis overlap) tended to suffer from poorer
the prevalence of post-TB bronchiectasis (16 from lung function and a higher mortality than those
Europe, 7 from Asia, 4 from South America, 1 from North without.63–65 More importantly, it has been suggested
America and 1 from Africa). Noticeably, the prevalence that COPD-bronchiectasis overlap might be indeed a
of post-TB in Asian was significantly higher than that unique phenotype. However, there remains to be
in Europe (68.5% vs 53.7%, P < 0.001) (Table 3). concerns regarding the temporal relationship and the
predominance between COPD and bronchiectasis,
which still poses significant challenge in our clinical
DISCUSSION practice. Hence, there is an urgent need to better
understand its epidemiology, natural history and
There are a wide range of disorders that can lead to the treatment.66
pathogenesis of bronchiectasis; therefore, the Meanwhile, 18.3% of patients had an underlying
awareness of specific aetiology may have a clinically cause that required a directed treatment or genetic
Respirology (2016) © 2016 Asian Pacific Society of Respirology
 Aetiology in bronchiectasis

Table 2 Risk factor for development of bronchiectasis in different geographic regions

Asia Europe North America South America Africa Oceania

© 2016 Asian Pacific Society of Respirology

Risk factors (n = 8) (n = 35) (n = 1) (n = 5) (n = 1) (n = 6) P*

Total 1198 6364 106 308 32 600

Idiopathic bronchiectasis 709 (59.2%) 2616 (41.1%) 7 (6.6%) 115 (37.3%) 8 (25%) 402 (67%) <0.001
Post-infective bronchiectasis 273 (22.8%) 1984 (31.2%) 20 (18.9%) 147 (47.7%) 20 (62.5%) 129 (21.5%) <0.001
Immunodeficiency 37 (3.1%) 337 (5.3%) 18 (17.0%) 6 (1.9%) 0 (0.0%) 31 (5.2%) <0.001
Chronic obstructive pulmonary disease 1 (0.1%) 329 (5.2%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 3 (0.5%) <0.001
Connective tissue disease 33 (2.8%) 252 (4.0%) 30 (28.3%) 6 (1.9%) 0 (0.0%) 5 (0.8%) <0.001
Allergic bronchopulmonary aspergillosis 26 (2.2%) 181 (2.8%) 1 (0.9%) 1 (0.3%) 0 (0.0%) 14 (2.3%) <0.001
Ciliary dysfunction 25 (2.1%) 172 (2.7%) 3 (2.8%) 11 (3.6%) 2 (6.3%) 5 (0.8%) <0.001
Asthma 10 (0.8%) 107 (1.7%) 0 (0.0%) 3 (1.0%) 0 (0.0%) 0 (0.0%) <0.001
Inflammatory bowel disease 2 (0.2%) 61 (1.0%) 3 (2.8%) 0 (0.0%) 0 (0.0%) 0 (0.0%) <0.001
Obstructive 3 (0.3%) 45 (0.7%) 16 (15.1%) 1 (0.3%) 1 (3.1%) 1 (0.2%) <0.001
Aspiration/esophageal reflux 10 (0.8%) 31 (0.5%) 12 (11.3%) 7 (2.3%) 1 (3.1%) 3 (0.5%) <0.001
Congenital malformation 8 (0.7%) 25 (0.4%) 1 (0.9%) 3 (1.0%) 0 (0.0%) 0 (0.0%) <0.001
α1-Antitrypsin deficiency 0 (0.0%) 23 (0.4%) 12 (11.3%) 1 (0.3%) 0 (0.0%) 0 (0.0%) <0.001
Diffuse panbronchiolitis 22 (1.8%) 5 (0.1%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) <0.001
Pink’s disease 0 (0.0%) 9 (0.1%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 11 (1.8%) <0.001
Yellow nail syndrome 1 (0.1%) 10 (0.2%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) <0.001
Others 36 (3.0%) 204 (3.2%) 2 (1.9%) 5 (1.6%) 0 (0.0%) 3 (0.5%) 0.001

*P value with respect to the difference among the studies, the chi-square or Fisher’s exact test was used to compare the unique etiologic spectra among different regions when appropriate.

Respirology (2016)
5
6 Y-H Gao et al.
Table 3 Tuberculosis (TB) as risk factors for the
development of bronchiectasis in adults among different
regions (n = 1271)
TB
Location/No. of studies
N Total % P
Asia (n = 7) 148 216 68.5 <0.001
Europe (n = 16) 481 896 53.7
North America (n = 1) 0 10 0.0
South America (n = 4) 75 129 58.1
Africa (n = 1) 12 20 60.0
screening/consultation in our study, which was in line
with the largest cohort study conducted in six European
countries5 showing that 13% of bronchiectasis
aetiologies were association with significantly improved
outcomes following adequate treatment. This has again
justified the significance of meticulous and thorough
etiologic assessment in bronchiectasis, which would
translate into better long-term prognosis.
There are several possible explanations for the
observed significant variation of the identified causes
reported in the literature. A number of studies included
in this systematic review were retrospective in design,
leading the possibility of patients being missed.
Meanwhile, the differences in the diagnostic workup
and inclusion criteria might have also contributed to
the variation in estimates observed herein. For instance,
multiple studies provided limited or no detail regarding
the diagnostic scheme for identifying the aetiology of
bronchiectasis, which might have overestimated the
proportion of patients with idiopathic bronchiectasis.
Furthermore, dual or even triple aetiologies for
bronchiectasis in individual patients have been
reported in three studies,3,6,27 raising the concern of
overrepresentation of certain specific causes.
Notably, there were significant differences in etiologic
spectra among patients with bronchiectasis in different
geographic regions. The reason for this disparity was
unclear but might be associated with the following: (i)
the differing patient populations assessed; (ii) the
varying number of available studies included; and (iii)
the individual study variation. Further etiologic
investigations are required in a larger patient
population, as recommended by the 2010 British
Thoracic Society guidelines.2
Relevant studies that met the criteria for this
systematic review were not frequently found in the
literature from North America (n = 1) and Africa (n = 1),
which increased the risk of selection bias and limited
the generalizability of our conclusions. As only studies
published in English were included, we may have
missed relevant data on aetiology studies in
bronchiectasis patients in non-English literature.
Similarly, we have limited our review to papers indexed
in MEDLINE and EMBASE, and there was the possibility
that we did not include relevant data that were
published outside of these databases. Nevertheless,
the strength of this study was the systematic analytical
methodology. In addition, while other investigations
have reported the bronchiectasis aetiologies in children
Respirology (2016)
bronchiectasis, this review provides the first summary
of aetiologies in adults with bronchiectasis globally.
Although this review summarized data on
aetiologies in adults, the wide range of prevalence of
underlying causes described herein reflects the varying
diagnostic scheme utilized in individual studies. To
minimize heterogeneity, further studies should
employ protocol-driven workup recommended by
British Thoracic Society guideline2and report specific
entity (e.g. type of immunodeficiency) to identify the
aetiologies of bronchiectasis. Additional research on
the independent effects of patient characteristics (i.e.
age, gender, ethnicity and disease severity) versus the
effects of specific aetiology on morbidity and mortality
would aid in our understanding of the overall impact of
identifying aetiologies on the clinical course of
bronchiectasis. Additionally, the design of future
clinical trials stratified by specific aetiologies might
lead to a better understanding of the bona fide
therapeutic outcomes.
Acknowledgements
This work was supported by funding from the National Natural
Science Foundation of China (No. 81500006 and 81400010) and
Scientific Research Projects for Medical Doctors and Researchers
from Overseas, Guangzhou Medical University (No. 2014C21). None
of the funding sources had any role on the study.
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Supplementary Information
Additional Supplementary Information can be accessed via the html
version of this article at the publisher’s website:
Table S1 Characteristics of included studies in this systematic review.
Table S2 Risk factors for development of adult bronchiectasis in 56
studies.
© 2016 Asian Pacific Society of Respirology