Latin America validation of FACED score in patients with bronchiectasis: an analysis of six cohorts

• Published in: BMC pulmonary medicine Vol. 17; no. 1; pp. 73 - 9
• Main Authors: Athanazio, Rodrigo, Pereira, Mônica Corso, Gramblicka, Georgina, Cavalcanti-Lundgren, Fernando, de Figueiredo, Mara Fernandes, Arancibia, Francisco, Rached, Samia, de la Rosa, David, Máiz-Carro, Luis, Girón, Rosa, Olveira, Casilda, Prados, Concepción, Martinez-Garcia, Miguel Angel
• Format: Journal Article
• Language: English
• Published: England BioMed Central 26.04.2017; BMC
• Subjects: Adult; Area Under Curve; Bronchiectasis; Bronchiectasis - mortality; Bronchiectasis - physiopathology; Cause of Death; Chronic obstructive pulmonary disease; Comorbidity; Cystic fibrosis; Disease Progression; FACED score; Female; Forced Expiratory Volume; Hospital Mortality - trends; Hospitalization; Hospitalization - statistics & numerical data; Humans; Kaplan-Meier Estimate; Latin America - epidemiology; Male; Medical prognosis; Middle Aged; Mortality; Prognosis; Pulmonology; Retrospective Studies; Risk Factors; ROC Curve; Severity of Illness Index; Validation studies; Latin America; Bronchiectasis; Prognosis; Mortality; FACED score; Validation studies
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-017-0417-3

The FACED score is an easy-to-use multidimensional grading system that has demonstrated an excellent prognostic value for mortality in patients with bronchiectasis. A Spanish group developed the score but no multicenter international validation has yet been published. Retrospective and multicenter study conducted in six historical cohorts of patients from Latin America including 651 patients with bronchiectasis. Clinical, microbiological, functional, and radiological variables were collected, following the same criteria used in the original FACED score study. The vital status of all patients was determined in the fifth year of follow-up. The area under ROC curve (AUC-ROC) was used to calculate the predictive power of the FACED score for all-cause and respiratory deaths and both number and severity of exacerbations. The discriminatory power to divide patients into three groups of increasing severity was also analyzed. Mean (SD) age of 48.2 (16), 32.9% of males. The mean FACED score was 2.35 (1.68). During the follow up, 95 patients (14.6%) died (66% from respiratory causes). The AUC ROC to predict all-cause and respiratory mortality were 0.81 (95% CI: 0.77 to 0.85) 0.84 (95% CI: 0.80 to 0.88) respectively, and 0.82 (95% CI: 078-0.87) for at least one hospitalization per year. The division into three score groups separated bronchiectasis into distinct mortality groups (mild: 3.7%; moderate: 20.7% and severe: 48.5% mortality; p < 0.001). The FACED score was confirmed as an excellent predictor of all-cause and respiratory mortality and severe exacerbations, as well as having excellent discriminative capacity for different degrees of severity in various bronchiectasis populations.