Severity assessment of non-cystic fibrosis bronchiectasis by the FACED score

Abstract

Objectives: Bronchiectasis (BE) is a major health problem associated with a high morbidity and mortality. This study aimed to determine the relation of the FACED score (a multidimensional score contributing to stratify patients into risk categories) with the severity of non-cystic fibrosis bronchiectasis (NCFB) among our population. Materials and Methods: This is a retrospective single center study of 105 consecutive patients with NCFB hospitalized for acute exacerbations (AE) at the Department of Respiratory Medicine of Fattouma Bourguiba Teaching Hospital in Monastir (Tunisia) between January 2005 and December 2017. Patients were divided into two groups (G): G1: FACED Score ≤ 2 and G2: FACED score ≥3. We compared different severity parameters of BE between the two groups. Results: The study included 105 patients with NCFB. Patients of G2 had more comorbidities (P = 0.028), an altered respiratory function with a lower forced vital capacity (G1:2.73, G2:1.33 L; P < 0.001), a decreased PaO2 (88 vs. 68 mmHg; P < 0.001), a high CO2 level (P < 0.001), and a higher number of AE/year (0.96, 2.12 AE/year;P < 0.001). Hospitalizations for AE of G2 were characterized by a lower PaO2, a higher PaCO2 (P < 0.001), a longer course of antibiotic (P < 0.001) with an extended hospitalization (P = 0.007). An ultimate evolution toward chronic respiratory failure was more common in G2 (P < 0.001). Conclusion: A high FACED score is associated with more symptoms, an altered respiratory function, a higher number and more severe AE, more health-care utilization with worse outcomes. Further studies are necessary to evaluate the impact of such scales in clinical practice.