FACED Score Predicts Mortality, Disease Severity, Exacerbations in Bronchiectasis Patients

FACED Score Predicts Mortality, Disease Severity, Exacerbations in Bronchiectasis Patients

The FACED score is a valuable tool to predict mortality, disease severity, and exacerbations in patients with bronchiectasis, according to new research.

The study, “Latin America validation of FACED score in patients with bronchiectasis: an analysis of six cohorts,” was published in the journal BMC Pulmonary Medicine.

Several factors contribute to the development of bronchiectasis, so analyzing a single factor cannot provide an accurate patient prognosis.

In recent years, two scores were developed to predict mortality in patients with bronchiectasis: the FACED score and the Bronchiectasis Severity Index (BSI).

“The FACED score is a simple score that consists of five dichotomized variables: age, clinical aspects (dyspnea), lung function (FEV1), microbiology (chronic bronchial infection by Pseudomonas aeruginosa), and radiological findings (number of affected lung lobes in computed tomography),” the researchers wrote.

“This score was developed by a Spanish group in 398 patients and showed excellent internal validity in 411 additional patients,” they added.

The score demonstrated the power to predict mortality within five years of diagnosis, and its longer-term prognostic capacity — up to 15 years — was confirmed by other European patients, the team noted.

To confirm the validity of this tool, researchers analyzed medical record data of 651 patients with a mean age of 48.2 years who had bronchiectasis from six groups of Latin American patients.

The data included clinical, microbiological, functional, and radiological parameters, which were analyzed according to the criteria of the FACED score. The team also checked whether patients were still alive after five years of follow-up.

The objective was to investigate whether the FACED score could accurately predict all-cause and respiratory deaths, as well as the number and severity of exacerbations.

Results showed that 95 patients (14.6%) died during follow-up, mainly due to respiratory causes (66%).

The FACED score predicted all-cause and respiratory mortality with an 81% and 82% accuracy, respectively. It also helped divide patients into three groups according to disease mortality: mild, 3.7%; moderate, 20.7%; and severe, 48.5% mortality.

The score also predicted patients with more severe exacerbations (meaning at least one hospitalization per year) with an 82% accuracy, and patients with more frequent and relevant exacerbations (at least two exacerbations a year or one hospitalization a year) with a 78% accuracy.

“The FACED score maintained its excellent ability to predict all-cause and respiratory mortality when tested in a Latin American population,” researchers wrote. “The score’s ability to discriminate between different degrees of bronchiectasis severity was also … validated… Furthermore, we significantly enhanced the clinical relevance of the FACED score since we also demonstrated its good discriminatory capacity for predicting multiple and severe exacerbations.”

More studies are warranted to assess whether this tool can also help predict other parameters, such as quality of life or loss of pulmonary function.

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