Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
Critical Medical Center, China Medical University Hospital, Taichung, Taiwan.
Eur J Med Res. 2024 May 14;29(1):286. doi: 10.1186/s40001-024-01870-z.
Our study aimed to confirm a simplified radiological scoring system, derived from a modified Reiff score, to evaluate its relationship with clinical symptoms and predictive outcomes in Taiwanese patients with noncystic fibrosis bronchiectasis (NCFB).
This extensive multicenter retrospective study, performed in Taiwan, concentrated on patients diagnosed with NCFB verified through high-resolution computed tomography (HRCT) scans. We not only compared the clinical features of various types of bronchiectasis (cylindrical, varicose, and cystic). Furthermore, we established relationships between the severity of clinical factors, including symptom scores, pulmonary function, pseudomonas aeruginosa colonization, exacerbation and admission rates, and HRCT parameters using modified Reiff scores.
Data from 2,753 patients were classified based on HRCT patterns (cylindrical, varicose, and cystic) and severity, assessed by modified Reiff scores (mild, moderate, and severe). With increasing HRCT severity, a significant correlation was found with decreased forced expiratory volume in the first second (FEV1) (p < 0.001), heightened clinical symptoms (p < 0.001), elevated pathogen colonization (pseudomonas aeruginosa) (p < 0.001), and an increased annual hospitalization rate (p < 0.001). In the following multivariate analysis, elderly age, pseudomonas aeruginosa pneumonia, and hospitalizations per year emerged as the only independent predictors of mortality.
Based on our large cohort study, the simplified CT scoring system (Reiff score) can serve as a useful adjunct to clinical factors in predicting disease severity and prognosis among Taiwanese patients with NCFB.
本研究旨在确认一种简化的放射学评分系统,该系统源自改良的 Reiff 评分,以评估其与台湾非囊性纤维化支气管扩张症(NCFB)患者临床症状的关系及其预测结果。
这项广泛的多中心回顾性研究在台湾进行,集中于通过高分辨率计算机断层扫描(HRCT)扫描确诊的 NCFB 患者。我们不仅比较了各种类型支气管扩张症(柱状、静脉曲张和囊性)的临床特征,还通过改良 Reiff 评分建立了临床因素严重程度(包括症状评分、肺功能、铜绿假单胞菌定植、恶化和入院率)与 HRCT 参数之间的关系。
根据 HRCT 模式(柱状、静脉曲张和囊性)和改良 Reiff 评分(轻度、中度和重度)将 2753 例患者的数据进行分类。随着 HRCT 严重程度的增加,与用力呼气量第一秒(FEV1)下降(p<0.001)、临床症状加重(p<0.001)、病原体定植(铜绿假单胞菌)升高(p<0.001)和年住院率增加(p<0.001)显著相关。在随后的多变量分析中,年龄较大、铜绿假单胞菌肺炎和每年住院次数是唯一与死亡率相关的独立预测因素。
基于我们的大型队列研究,简化 CT 评分系统(Reiff 评分)可作为临床因素的有用补充,有助于预测台湾 NCFB 患者的疾病严重程度和预后。