Non-Cystic Fibrosis Bronchiectasis Severity Successfully Assessed by Two Grading Scores

Non-Cystic Fibrosis Bronchiectasis Severity Successfully Assessed by Two Grading Scores

A team led by researchers at The Institute for Occupational Health of R. Macedonia reported that two distinct grading scores, the FACED score and the Bronchiectasis Severity Index, are both reliable tools to assess disease severity in non-cystic fibrosis bronchiectasis patients. The study was published in The Open Respiratory Medicine Journal and is entitled “Assessment of the Non-Cystic Fibrosis Bronchiectasis Severity: The FACED Score vs the Bronchiectasis Severity Index.

Bronchiectasis is a respiratory condition characterized by a chronic inflammation that usually results from an infection or other condition that injures the walls of the airways, causing irreversible airway dilatation and scarring. In bronchiectasis, the airways slowly lose their ability to clear out mucus, so it accumulates in the lungs, creating an environment prone to bacteria growth that can lead to severe lung infections. Sputum production, chronic cough and recurrent chest infections are signs of the disease.

Bronchiectasis can be associated with cystic fibrosis, a serious genetic disease, or  bacterial infections – non-cystic fibrosis bronchiectasis (NCFB). NCFB is a common, chronic medical condition affecting around 110,000 adult individuals in the United States, however, many experts believe the condition is drastically under diagnosed.

Assessment of the severity and prognosis of NCFB in patients in routine clinical practice is important for early employment of the most appropriate treatment and to improve the patient’s quality of life. Two grading systems have been developed to classify disease severity, the FACED score (forced expiratory volume in 1 second (FEV1) % predicted [F], age [A], chronic colonization by Pseudomonas aeruginosa [C], extension of the disease by radiological assessment [E] and dyspnea [D]) based on five parameters and the Bronchiectasis Severity Index (BSI) which is based on seven parameters.

In this study, researchers conducted an observational study where they analyzed both scores as predictors of NCFB severity and prognosis in the same cohort of 37 NCFB patients, aged 46 to 76 years.

Researchers found that based on the FACED score, 46% of the patients had mild bronchiectasis, 38% moderate bronchiectasis and 16% severe bronchiectasis. According to the BSI score, 43% of the patients had low scores, 38% had intermediate values and 19% had high values.

The team concluded that both FACED and BSI scores yielded similar results regarding disease severity in NCFB patients, and suggests that further studies should be conducted to determine how these grading scores can have a useful application in clinical practice.