RT Journal Article
SR Electronic
T1 Comparative analysis of the predictive utility of clinical disease severity scores for non-cystic fibrosis bronchiectasis
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2484
VO 44
IS Suppl 58
A1 Melissa McDonnell
A1 Pieter Goeminne
A1 Stefano Alberti
A1 John Davison
A1 Sara Lonni
A1 Lucy Poppelwell
A1 Waleed Salih
A1 Alberto Pesci
A1 Tom Fardon
A1 Lieven Dupont
A1 Adam Hill
A1 Anthony De Soyza
A1 James Chalmers
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P2484.abstract
AB Background: Non-cystic fibrosis bronchiectasis is a multidimensional disease associated with increased morbidity and mortality. Two composite disease-specific clinical prediction tools have been developed and validated, the Bronchiectasis Severity Index (BSI) and FACED score; both objectively stratify patients into risk categories to predict the probability of mortality and other clinical outcomes.Methods: The utility of the BSI and FACED to predict mortality and hospital admission rates across overall and risk-stratified groups in five international cohorts and combined meta-analysis was assessed using the area under the receiver operator characteristic curve (AUC). An AUC>0.8 is considered excellent.Results: All cohorts totalled 1310 patients: median age 66 yrs (IQ range 57-75), 43.1% male, all-cause mortality 9.7%, hospitalisation rate 31.3%. Mortality rates ranged from 1.9%(Monza) to 16.6%(Leuven) with a range in hospitalisation from 26.6%(Dundee) to 45.3%(Newcastle). The AUC for BSI vs. FACED-predicted mortality was 0. 80 vs. 0.73(Edinburgh), 0.84 vs. 0.74(Dundee), 0.82 vs. 0.68(Newcastle) and 0.81 vs. 0.78(Leuven). The AUC for BSI vs. FACED-predicted hospitalisation was 0.88 vs. 0.70(Edinburgh), 0.82 vs. 0.63(Dundee), 0.80 vs. 0.56(Newcastle) and 0.88 vs. 0.63(Monza). Categorisation by risk in meta-analysis and individual cohorts showed the BSI to be superior to FACED in predicting both outcomes.Conclusion: The BSI scored consistently higher than FACED across combined, total individual and risk-stratified patient groups with a higher discriminative ability in calculating the probability of mortality and hospital admissions in bronchiectasis patients.