Multidimensional approach to non-cystic fibrosis bronchiectasis: the FACED score.
Bronchiectasis is a multidimensional disease and, therefore, its severity or prognosis cannot be adequately quantified by analysing one single variable. The objective of the present study was to develop a multidimensional score that classifies the severity of bronchiectasis according to its prognosis. This is an observational multicentre study including 819 patients diagnosed with non-cystic fibrosis bronchiectasis using high-resolution computed tomography. 397 subjects were selected at random to construct the score while the remaining 422 were used for its validation. The outcome was 5-year all-cause mortality after radiological diagnosis. A logistic regression analysis was used to select the variables included in the final score. The final seven-point score incorporated five dichotomised variables: forced expiratory volume in 1 s % predicted (F, cut-off 50%, maximum value 2 points); age (A, cut-off 70 years, maximum value 2 points); presence of chronic colonisation by Pseudomonas aeruginosa (C, dichotomic, maximum value 1 point); radiological extension (E, number of lobes affected, cut-off two lobes, maximum value 1 point); and dyspnoea (D, cut-off grade II on the Medical Research Council scale, maximum value 1 point) to construct the FACED score. The validation cohort confirmed the score's validity. We conclude that this easy-to-use multidimensional grading system proved capable of accurately classifying the severity of bronchiectasis according to its prognosis.
Hospital Universitario y Politécnico La Fe, Valencia.
Miguel Á
MÁ
Martínez-García
Javier
J
de Gracia
Monserrat
M
Vendrell Relat
Rosa-Maria
RM
Girón
Luis
L
Máiz Carro
David
D
de la Rosa Carrillo
Casilda
C
Olveira
D000368:Aged; D019540:Area Under Curve; D001987:Bronchiectasis / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D015272:Pulmonary Medicine / Q000379:methods / Q000592:standards; D012044:Regression Analysis; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome