The BRICS (Bronchiectasis Radiologically Indexed CT Score) A Multicenter Study Score for Use in Idiopathic and Postinfective Bronchiectasis

被引:53
作者
Bedi, Pallavi [1 ]
Chalmers, James D. [2 ]
Goeminne, Pieter C. [7 ]
Mai, Cindy [8 ]
Saravanamuthu, Pira [3 ]
Velu, Prasad Palani [3 ]
Cartlidge, Manjit K. [1 ]
Loebinger, Michael R. [4 ]
Jacob, Joe [4 ]
Kamal, Faisal [4 ]
Schembri, Nicola [2 ]
Aliberti, Stefano [5 ,6 ]
Hill, Uta [9 ]
Harrison, Mike [9 ]
Johnson, Christopher [9 ]
Screaton, Nicholas [9 ]
Haworth, Charles [9 ]
Polverino, Eva [10 ]
Rosales, Edmundo [10 ]
Torres, Antoni [10 ]
Benegas, Michael N. [10 ]
Rossi, Adriano G. [1 ]
Patel, Dilip [3 ]
Hill, Adam T. [1 ,3 ]
机构
[1] Queens Med Res Inst, MRC Ctr Inflammat Res, 47 Little France Crescent, Edinburgh EH16 4TJ, Midlothian, Scotland
[2] Univ Dundee, Sch Med, Dundee, Scotland
[3] Royal Infirm Edinburgh NHS Trust, Edinburgh, Midlothian, Scotland
[4] Royal Brompton, London, England
[5] Univ Milan, Internal Med Dept, Dept Pathophysiol & Transplantat, Resp Unit, Milan, Italy
[6] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Cyst Fibrosis Adult Ctr, Milan, Italy
[7] AZ Nikolaas, Dept Resp Dis, St Niklaas, Belgium
[8] Univ Hosp Leuven, Dept Radiol, Leuven, Belgium
[9] Papworth Hosp, Cambridge Ctr Lung Infect, Cambridge, England
[10] Hosp Clin Barcelona, Inst Clin Torax, Barcelona, Spain
关键词
bronchiectasis; CT scan; scoring system; CYSTIC FIBROSIS BRONCHIECTASIS; PULMONARY-FUNCTION TESTS; THIN-SECTION CT; COMPUTED-TOMOGRAPHY; NEUTROPHIL ELASTASE; FEATURES; DIAGNOSIS;
D O I
10.1016/j.chest.2017.11.033
中图分类号
R4 [临床医学];
学科分类号
100218 [急诊医学];
摘要
OBJECTIVES: The goal of this study was to develop a simplified radiological score that could assess clinical disease severity in bronchiectasis. METHODS: The Bronchiectasis Radiologically Indexed CT Score (BRICS) was devised based on a multivariable analysis of the Bhalla score and its ability in predicting clinical parameters of severity. The score was then externally validated in six centers in 302 patients. RESULTS: A total of 184 high-resolution CT scans were scored for the validation cohort. In a multiple logistic regression model, disease severity markers significantly associated with the Bhalla score were percent 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 operating-characteristic curve values for BRICS in the derivation cohort were 0.79 for percent predicted FEV1, 0.71 for sputum purulence, and 0.75 for hospital admissions per year; these values were 0.81, 0.70, and 0.70, respectively, in the validation cohort. Sputum free neutrophil elastase activity was significantly elevated in the group with emphysema on CT imaging. CONCLUSIONS: A simplified CT scoring system can be used as an adjunct to clinical parameters to predict disease severity in patients with idiopathic and postinfective bronchiectasis.
引用
收藏
页码:1177 / 1186
页数:10
相关论文
共 24 条
[2]
CYSTIC-FIBROSIS - SCORING SYSTEM WITH THIN-SECTION CT [J].
BHALLA, M ;
TURCIOS, N ;
APONTE, V ;
JENKINS, M ;
LEITMAN, BS ;
MCCAULEY, DI ;
NAIDICH, DP .
RADIOLOGY, 1991, 179 (03) :783-788
[3]
Scoring systems for CT in cystic fibrosis: Who cares? [J].
Brody, AS .
RADIOLOGY, 2004, 231 (02) :296-298
[4]
The Bronchiectasis Severity Index An International Derivation and Validation Study [J].
Chalmers, James D. ;
Goeminne, Pieter ;
Aliberti, Stefano ;
McDonnell, Melissa J. ;
Lonni, Sara ;
Davidson, John ;
Poppelwell, Lucy ;
Salih, Waleed ;
Pesci, Alberto ;
Dupont, Lieven J. ;
Fardon, Thomas C. ;
De Soyza, Anthony ;
Hill, Adam T. .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2014, 189 (05) :576-585
[5]
Short- and Long-Term Antibiotic Treatment Reduces Airway and Systemic Inflammation in Non-Cystic Fibrosis Bronchiectasis [J].
Chalmers, James D. ;
Smith, Maeve P. ;
McHugh, Brian J. ;
Doherty, Cathy ;
Govan, John R. ;
Hill, Adam T. .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2012, 186 (07) :657-665
[6]
Cherniack NS, 1996, AM J MED, V41, P564
[7]
Chua Felix, 2006, Proc Am Thorac Soc, V3, P424, DOI 10.1513/pats.200603-078AW
[8]
Matrix metalloproteinase activation by free neutrophil elastase contributes to bronchiectasis progression in early cystic fibrosis [J].
Garratt, Luke W. ;
Sutanto, Erika N. ;
Ling, Kak-Ming ;
Looi, Kevin ;
Iosifidis, Thomas ;
Martinovich, Kelly M. ;
Shaw, Nicole C. ;
Kicic-Starcevich, Elizabeth ;
Knight, Darryl A. ;
Ranganathan, Sarath ;
Stick, Stephen M. ;
Kicic, Anthony .
EUROPEAN RESPIRATORY JOURNAL, 2015, 46 (02) :384-394
[9]
BRONCHIECTASIS - ASSESSMENT BY THIN-SECTION CT [J].
GRENIER, P ;
MAURICE, F ;
MUSSET, D ;
MENU, Y ;
NAHUM, H .
RADIOLOGY, 1986, 161 (01) :95-99
[10]
VALUE OF MEDIUM-THICKNESS CT IN THE DIAGNOSIS OF BRONCHIECTASIS [J].
JOHARJY, IA ;
BASHI, SA ;
ADBULLAH, AK .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1987, 149 (06) :1133-1137