Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
College of Medicine Chang Gung University, Taoyuan, Taiwan.
Ann Med. 2021 Dec;53(1):2034-2040. doi: 10.1080/07853890.2021.1999490.
The bronchiectasis severity index (BSI) and FACED score are currently used in predicting outcomes of non-cystic fibrosis bronchiectasis (NCFB). Distance-saturation product (DSP), the product of distance walked, and lowest oxygen saturation during the 6-min walk test showed strong predictive power of mortality in non-CF bronchiectasis patients. This study aimed to compare the efficacy of these scores and DSP in predicting mortality.
Our retrospective study included NCFB patients from January 2004 to December 2017. We recorded the basic data, pulmonary function, radiologic studies, sputum culture results, acute exacerbations (AE), emergency department (ED) visits, hospitalization, and mortality.
A total 130 NCFB patients were analysed. The mean BSI score, FACED score, and DSP were 8.8 ± 4.9, 3.4 ± 1.7, and 413.1 ± 101.5 m%, respectively. BSI and FACED scores had comparable predictive power for AE (=.011; =.010, respectively). The BSI score demonstrated a significant correlation with ED visits (=.0003). There were 12 deaths. Patients were stratified using a DSP cut-off value of 345 m% according to the best area under receiver operator characteristic curve (AUC) value in mortality. DSP was not correlated with AE and ED visits. BSI, FACED scores, and DSP demonstrated statistically significant correlations with hospitalization (<.0001; <.0001; =.0007, respectively). The AUC for overall mortality was similar for BSI, FACED score, and DSP (0.80 versus 0.85, =.491; 0.85 versus 0.83, =.831).
DSP had comparable predictive power for mortality as the well-validated BSI and FACED scores and is relatively easy to use in clinical practice.KEY MESSAGEDistance-saturation product (DSP) comprised with the product of distance walked, and lowest oxygen saturation during the 6-min walk test, which is common used in clinical practice.DSP demonstrated strong and comparable predictive power of mortality as the well-validated BSI and FACED scores in non-CF bronchiectasis patients.
支气管扩张严重指数(BSI)和 FACED 评分目前用于预测非囊性纤维化支气管扩张症(NCFB)的结局。距离-饱和度乘积(DSP),即 6 分钟步行试验中行走距离与最低血氧饱和度的乘积,在非 CF 支气管扩张症患者的死亡率预测方面具有很强的预测能力。本研究旨在比较这些评分和 DSP 预测死亡率的疗效。
我们的回顾性研究纳入了 2004 年 1 月至 2017 年 12 月的 NCFB 患者。我们记录了基本数据、肺功能、影像学研究、痰培养结果、急性加重(AE)、急诊科(ED)就诊、住院和死亡率。
共分析了 130 例 NCFB 患者。BSI 评分、FACED 评分和 DSP 的平均值分别为 8.8±4.9、3.4±1.7 和 413.1±101.5 m%。BSI 和 FACED 评分对 AE 的预测能力相当(=0.011;=0.010)。BSI 评分与 ED 就诊呈显著相关(=0.0003)。共有 12 例死亡。根据死亡率最佳受试者工作特征曲线(AUC)值,根据 DSP 截断值 345 m%将患者分层。DSP 与 AE 和 ED 就诊无相关性。BSI、FACED 评分和 DSP 与住院治疗呈显著相关(<0.0001;<0.0001;=0.0007,分别)。BSI、FACED 评分和 DSP 对总死亡率的 AUC 相似(0.80 与 0.85,=0.491;0.85 与 0.83,=0.831)。
DSP 在预测死亡率方面与经过充分验证的 BSI 和 FACED 评分具有相当的预测能力,并且在临床实践中相对容易使用。
DSP 由 6 分钟步行试验中行走距离与最低血氧饱和度的乘积组成,在临床实践中常用。DSP 在非 CF 支气管扩张症患者中具有与经过充分验证的 BSI 和 FACED 评分相当的强大且可比的死亡率预测能力。