Chalmers et al developed the Bronchiectasis Severity Index (BSI) for clinical evaluation of a patient with bronchiectasis. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple hospitals in Europe.
Patient selection: adult with bronchiectasis
Parameters:
(1) age of the patient in years
(2) body mass index (BMI) in kilograms per square meter
(3) FEV1 as percent of predicted
(4) history of hospital admission prior to study
(5) number of previous exacerbations (excludes current status)
(6) MRC dyspnea scale from 1 to 5
(7) colonization with Pseudomonas
(8) colonization with other bacteria
(9) number of lobes involved by cystic bronchiectasis on chest imaging studies
|
Parameter |
Finding |
Points |
|
age in years |
< 50 years |
0 |
|
|
50 to 69 years |
2 |
|
|
70 to 79 years |
4 |
|
|
>= 80 years |
6 |
|
BMI |
<18. 5 kg per sq m |
2 |
|
|
>= 18.5 |
0 |
|
FEV1 percent of predicted |
> 80% |
0 |
|
|
50 to 80% |
1 |
|
|
30 to 49% |
2 |
|
|
< 30% |
3 |
|
hospital admission before |
no |
0 |
|
|
yes |
5 |
|
exacerbations |
0 to 2 |
0 |
|
|
3 or more |
2 |
|
MRC dyspnea scale |
1 to 3 |
0 |
|
|
4 |
2 |
|
|
5 |
3 |
|
Pseudomonas colonization |
no |
0 |
|
|
yes |
3 |
|
other bacteria colonization |
no |
0 |
|
|
yes |
1 |
|
lobes with cystic bronchiectasis |
0 to 2 |
0 |
|
|
3 to 5 |
1 |
total score =
= SUM(points for all 9 parameters)
Interpretation:
• minimum score: 0
• maximum score: 26
|
Total Score |
Hospitalization |
Mortality |
|
0 to 4 |
8% |
3% |
|
5 to 8 |
15% |
7% |
|
9 or more |
76% |
24% |
Performance:
• The area under the ROC curve is 0.80 for mortality and 0.88 for hospitalization.
Specialty: Pulmonology
