Bronchiectasis Severity Index
The Bronchiectasis Severity Index (BSI), which uses a combination of clinical, radiological and microbiological features, is a strong predictor of morbidity and mortality and predicts one and four year morbidity and mortality (Chalmers et al 2014) for patients with non-CF bronchiectasis. This assessment of severity tool was also found to give excellent predictions of hospital admissions, exacerbations and quality of life.
Identification of high risk patients may be a very valuable to guide clinical decision making, such as the frequency and intensity of follow-up and the use of chronic antibiotic therapy.
The BSI and the FACED score were compared in The Open Respiratory Medicine Journal: “Assessment of the Non-Cystic Fibrosis Bronchiectasis Severity: The FACED Score vs the Bronchiectasis Severity Index”. The authors found similar results regarding the assessment of severity of disease for both tools.
The BSI uses the following criteria and is calculated with the assistance of the Online Calculation Tool:
Previous Hospital Admission
Has the patient been hospitalised with a severe exacerbation in the past 2 years?
Number of exacerbations in previous year
Pseudomonas colonisation (chronic colonisation is defined by the isolation of Pseudomonas aeriginosa in sputum culture on 2 or more occasions, at least 3 months apart in a 1 year period)
Colonisation with other organisms (chronic colonisation is defined by the isolation of potentially pathogenic bacteria in sputum culture on 2 or more occasions, at least 3 months apart in a 1 year period)
Bronchiectasis Severity Score (calculated from results of the above criteria)
0- 4 Mild Bronchiectasis
1 year outcomes: 0 – 2.8 % mortality rate, 0 – 3.4 % hospitalisation rate
4 year outcomes: 0 – 5.3 % mortality rate, 0 – 9.2 % hospitalisation rate
5 – 8 Moderate Bronchiectasis
1 year outcomes: 0.8 – 4.8 % mortality rate, 1.0 – 7.2 % hospitalisation rate
4 year outcomes: 4 % – 11.3 % mortality rate, 9.9 – 19.4 % hospitalisation rate
9 + Severe Bronchiectasis
1 year outcomes: 7.6 % – 10.5 % mortality rate, 16.7 – 52.6 % hospitalisation rate
4 year outcomes: 9.9 – 29.2 % mortality, 41.2 – 80.4 % hospitalisation rate