Objectives: The aim of our study was to develop a simplified radiological score that could assess clinical disease severity in bronchiectasis.
Methods: The BRICS (Bronchiectasis Radiologically Indexed CT Score) was devised based on multivariable analysis of the Bhalla score and their ability in predicting clinical parameters of severity. The score was then externally validated in 6 centers in 302 patients.
Result: 184 HRCT scans were scored for the validation cohort. In a multiple logistic regression model, disease severity markers significantly associated with the Bhalla score were percentage predicted FEV1, sputum purulence and exacerbations requiring hospital admission. Components of the Bhalla score that were significantly associated with the disease severity markers were bronchial dilatation and number of bronchopulmonary segments with emphysema. The BRICS was developed with these two parameters. The receiver operator curve values for BRICS in the derivation cohort were 0.79 for percentage predicted FEV1, 0.71 for sputum purulence and 0.75 for hospital admissions/year; and 0.81, 0.70 and 0.70 respectively in the validation cohort. Sputum free neutrophil elastase was significantly elevated in the group with emphysema on CT.
Conclusion: A simplified CT scoring system can be used as an adjunct to clinical parameters to predict disease severity in patients with idiopathic and post-infective bronchiectasis.
- Journal article
- CT scan
- scoring system