The Bronchiectasis Severity Index and FACED score for assessment of the severity of bronchiectasis

Introduction Bronchiectasis (BC) is a multidimensional and etiologically diverse disease and, therefore, no single parameter can be used to determine its overall severity and prognosis. In this regard, two different validated scores are currently used to assess the severity of non-cystic fibrosis br...

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Main Authors: J.C. Costa, J.N. Machado, C. Ferreira, J. Gama, C. Rodrigues
Format: Article
Language:English
Published: Taylor & Francis 2018-05-01
Series:Pulmonology
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Online Access:https://www.tandfonline.com/doi/10.1016/j.rppnen.2017.08.009
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author J.C. Costa
J.N. Machado
C. Ferreira
J. Gama
C. Rodrigues
author_facet J.C. Costa
J.N. Machado
C. Ferreira
J. Gama
C. Rodrigues
author_sort J.C. Costa
collection DOAJ
description Introduction Bronchiectasis (BC) is a multidimensional and etiologically diverse disease and, therefore, no single parameter can be used to determine its overall severity and prognosis. In this regard, two different validated scores are currently used to assess the severity of non-cystic fibrosis bronchiectasis (NCFB): the FACED score and the Bronchiectasis Severity Index (BSI).Objective To describe the etiology of NCFB and compare the results of the assessment of NCFB severity obtained via FACED and BSI scores.Methods Retrospective study of demographic and clinical data of a convenience sample of NCFB patients attending the Functional Breathing Re-adaptation appointment at the Pneumology B Unit, University Hospital Center of Coimbra. All patients underwent evaluation of the variables incorporated in the FACED score (FEV1% predicted, age, chronic colonization by Pseudomonas aeruginosa, radiological extent of the disease, and dyspnea) and in the BSI (age, body mass index, FEV1% predicted, hospitalization and exacerbations before study, dyspnea, chronic colonization by P. aeruginosa and other microrganisms, and radiological extent of the disease). Statistical analysis of the data was performed using Microsoft Excel® and IBM SPSS® v23.Results The sample included 40 patients, 22 females and 18 males, aged 39–87 years. Regarding the etiology of NCFB, we found: idiopathic (60%), post-infectious (20%), sequelae of pulmonary tuberculosis (12.5%) and primary immunodeficiency related (7.5%).According to the FACED score we found 20 patients (50%) with mild BC, 15 patients (37.5%) with moderate and 5 patients (12.5%) with severe BC. The frequency of patients with low, intermediate and high BSI was 13 (32.5%), 13 (32.5%) and 14 (35%), respectively in relation to derived BSI, Moreover, we observed a weak but statistically significant association between FACED and BSI scores: Fisher's exact test (p = 0.004), tau-b de Kendall (0.469; p = 0.001). The Kappa test (0.330; p = 0.002) also shows us that there is 55% agreement between the two scales.Conclusion There is a small but significant correlation between the two scales: a tendency is observed for patients to be classified with a higher BSI compared to the FACED score. This can be explained by the fact that BSI (and not FACED) evaluates parameters including BMI, hospitalization and exacerbations before study, chronic colonization by other microorganisms and development of cystic bronchiectasis. Further studies should address how these scores may impact clinical practice.
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spelling doaj-art-0ccecbecda7046a7b6a025d7914df56d2025-08-20T03:48:13ZengTaylor & FrancisPulmonology2531-04292531-04372018-05-0124314915410.1016/j.rppnen.2017.08.009The Bronchiectasis Severity Index and FACED score for assessment of the severity of bronchiectasisJ.C. Costa0J.N. Machado1C. Ferreira2J. Gama3C. Rodrigues4Pneumology B Unit, University Hospital Center of Coimbra, Coimbra, PortugalPneumology B Unit, University Hospital Center of Coimbra, Coimbra, PortugalPneumology B Unit, University Hospital Center of Coimbra, Coimbra, PortugalMathematics Department, University of Beira Interior, Covilhã, PortugalPneumology B Unit, University Hospital Center of Coimbra, Coimbra, PortugalIntroduction Bronchiectasis (BC) is a multidimensional and etiologically diverse disease and, therefore, no single parameter can be used to determine its overall severity and prognosis. In this regard, two different validated scores are currently used to assess the severity of non-cystic fibrosis bronchiectasis (NCFB): the FACED score and the Bronchiectasis Severity Index (BSI).Objective To describe the etiology of NCFB and compare the results of the assessment of NCFB severity obtained via FACED and BSI scores.Methods Retrospective study of demographic and clinical data of a convenience sample of NCFB patients attending the Functional Breathing Re-adaptation appointment at the Pneumology B Unit, University Hospital Center of Coimbra. All patients underwent evaluation of the variables incorporated in the FACED score (FEV1% predicted, age, chronic colonization by Pseudomonas aeruginosa, radiological extent of the disease, and dyspnea) and in the BSI (age, body mass index, FEV1% predicted, hospitalization and exacerbations before study, dyspnea, chronic colonization by P. aeruginosa and other microrganisms, and radiological extent of the disease). Statistical analysis of the data was performed using Microsoft Excel® and IBM SPSS® v23.Results The sample included 40 patients, 22 females and 18 males, aged 39–87 years. Regarding the etiology of NCFB, we found: idiopathic (60%), post-infectious (20%), sequelae of pulmonary tuberculosis (12.5%) and primary immunodeficiency related (7.5%).According to the FACED score we found 20 patients (50%) with mild BC, 15 patients (37.5%) with moderate and 5 patients (12.5%) with severe BC. The frequency of patients with low, intermediate and high BSI was 13 (32.5%), 13 (32.5%) and 14 (35%), respectively in relation to derived BSI, Moreover, we observed a weak but statistically significant association between FACED and BSI scores: Fisher's exact test (p = 0.004), tau-b de Kendall (0.469; p = 0.001). The Kappa test (0.330; p = 0.002) also shows us that there is 55% agreement between the two scales.Conclusion There is a small but significant correlation between the two scales: a tendency is observed for patients to be classified with a higher BSI compared to the FACED score. This can be explained by the fact that BSI (and not FACED) evaluates parameters including BMI, hospitalization and exacerbations before study, chronic colonization by other microorganisms and development of cystic bronchiectasis. Further studies should address how these scores may impact clinical practice.https://www.tandfonline.com/doi/10.1016/j.rppnen.2017.08.009Non-cystic fibrosis bronchiectasisFACEDBSI
spellingShingle J.C. Costa
J.N. Machado
C. Ferreira
J. Gama
C. Rodrigues
The Bronchiectasis Severity Index and FACED score for assessment of the severity of bronchiectasis
Pulmonology
Non-cystic fibrosis bronchiectasis
FACED
BSI
title The Bronchiectasis Severity Index and FACED score for assessment of the severity of bronchiectasis
title_full The Bronchiectasis Severity Index and FACED score for assessment of the severity of bronchiectasis
title_fullStr The Bronchiectasis Severity Index and FACED score for assessment of the severity of bronchiectasis
title_full_unstemmed The Bronchiectasis Severity Index and FACED score for assessment of the severity of bronchiectasis
title_short The Bronchiectasis Severity Index and FACED score for assessment of the severity of bronchiectasis
title_sort bronchiectasis severity index and faced score for assessment of the severity of bronchiectasis
topic Non-cystic fibrosis bronchiectasis
FACED
BSI
url https://www.tandfonline.com/doi/10.1016/j.rppnen.2017.08.009
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