Affiliation:
1. Darwin Respiratory and Sleep Health Darwin Private Hospital Darwin Northern Territory Australia
2. Faculty of Health Charles Darwin University Darwin Northern Territory Australia
3. Department of Technical Physics University of Eastern Finland Kuopio Finland
4. Medical Imaging Kimberley Imaging Broome Western Australia Australia
5. Royal Australian and New Zealand College of Radiologists Sydney New South Wales Australia
6. Faculty of Medicine, Farhat HACHED Hospital, Heart Failure (LR12SP09) Research Laboratory University of Sousse Sousse Tunisia
7. Northern Institute, Faculty of Arts and Society Charles Darwin University Darwin Northern Territory Australia
8. Department of Respiratory and Sleep Medicine Royal Darwin Hospital Darwin Northern Territory Australia
9. College of Medicine and Public Health Flinders University Darwin Northern Territory Australia
10. Australasian Bronchiectasis Consortium Lung Foundation Brisbane Queensland Australia
Abstract
AbstractBackgroundThere is a lack of a comprehensive bronchiectasis severity assessment tool specific for Indigenous people that corrects for normative references established for the non‐Indigenous population.AimsAn innovative bronchiectasis assessment tool is developed for use in adult Indigenous patients – the Indigenous bronchiectasis assessment scale ‘(IBAS)’.MethodsA total of 454 adult Indigenous Australian patients, with chest CT confirmed bronchiectasis diagnosed between 2011 and 2020, were included. Age, sex, residence location, body mass index, radiological findings, sputum microbiology, lung function parameters and medical comorbidities were utilised to predict 5‐year all‐cause mortality and 5‐year hospitalisations. Scores of parameters with P < 0.20 from univariate Cox regressions were derived.ResultsThe resultant IBAS included age (<30, 30–50, 50–70 and 70+ years), urban residence, forced vital capacity (% predicted) (>50%, 30%–50% and <30%), right lower lobe involvement, history of Haemophilus spp., Pseudomonas spp., yeast spp. or Moraxella spp., 2‐year respiratory condition hospitalisation history (<2, 2 and 3+ admissions), and comorbid chronic obstructive pulmonary disease, asthma and arterial hypertension. The maximum score was 18, with thresholds at 0–4 (mild, n = 78, 34.4%), 5–7 (moderate, n = 111, 48.9%) and ≥ 8 (severe, n = 38, 16.7%). The area under the curve for 5‐year mortality was 0.743 (95% confidence interval (CI) 0.683, 0.803). The IBAS score demonstrated significant delineation in mortality between mild and moderate (moderate hazard ratio (HR) 3.45 (95% CI 1.57, 7.58)) and between moderate and severe (severe HR 2.43 (95% CI 1.45, 4.07)).ConclusionThe proposed IBAS tool could be of aid in assessing bronchiectasis severity in Indigenous patients.