Multidimensional approach to non-cystic fibrosis bronchiectasis: the FACED score

• Published in: The European respiratory journal Vol. 43; no. 5; pp. 1357 - 1367
• Main Authors: Martínez-García, Miguel Á., de Gracia, Javier, Vendrell Relat, Monserrat, Girón, Rosa-Maria, Máiz Carro, Luis, de la Rosa Carrillo, David, Olveira, Casilda
• Format: Journal Article
• Language: English
• Published: Leeds Maney 01.05.2014
• Subjects: Aged; Area Under Curve; Biological and medical sciences; Bronchiectasis - diagnosis; Bronchiectasis - diagnostic imaging; Cohort Studies; Errors of metabolism; Female; Follow-Up Studies; Forced Expiratory Volume; Humans; Kaplan-Meier Estimate; Male; Medical sciences; Metabolic diseases; Middle Aged; Miscellaneous hereditary metabolic disorders; Pneumology; Predictive Value of Tests; Prognosis; Pulmonary Medicine - methods; Pulmonary Medicine - standards; Regression Analysis; Respiratory system : syndromes and miscellaneous diseases; Severity of Illness Index; Tomography, X-Ray Computed; Treatment Outcome; Respiratory disease; Metabolic diseases; Digestive diseases; Bronchus disease; Cystic fibrosis; Surgical approach; Bronchiectasis; Genetic disease; Pancreatic disease
• ISSN: 0903-1936; 1399-3003; 1399-3003
• DOI: 10.1183/09031936.00026313

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.