BRICS- a simple radiological scoring in bronchiectasis

Abstract

Objectives: The aims of our study were to: (i) develop a simplified radiological score that could assess clinical disease severity in idiopathic and post-infective bronchiectasis; (ii) assess if free neutrophil elastase correlated to emphysema on CT. Methods: The BRICS (Bronchiectasis Radiologically Indexed CT Score) was devised based on multivariable analysis of the Bhalla score and its ability in predicting clinical parameters of severity. The score was validated in 6 centers in 302 patients. Result: 184 scans were scored. In a multiple linear regression model, disease severity markers significantly associated with the Bhalla score were %predicted FEV 1 , sputum purulence and exacerbations requiring hospital admission. Components of the Bhalla score that were significantly associated with disease severity markers were bronchial dilatation and number of bronchopulmonary segments with emphysema. BRICS was developed with these two parameters. The ROC values for BRICS in the derivation cohort were 0.79 for %predicted FEV 1 , 0.71 for sputum purulence and 0.75 for hospital admissions; and 0.81, 0.70 and 0.70 respectively in the validation cohort. Sputum was available in 113 patients of the derivation cohort. 57% of patients with emphysema on the CT scan had >5pg/ml on elastase in their sputum compared to 16% in the other group; p Conclusion: A simplified CT scoring system can be used as an adjunct to clinical parameters to predict disease severity in bronchiectasis.