The BRICS (Bronchiectasis Radiologically Indexed CT Score): A Multicenter Study Score for Use in Idiopathic and Postinfective Bronchiectasis

Pallavi Bedi, James D. Chalmers, Pieter C. Goeminne, Cindy Mai, Pira Saravanamuthu, Prasad Palani Velu, Manjit K. Cartlidge, Michael R. Loebinger, Joe Jacob, Faisal Kamal, Nicola Schembri, Stefano Aliberti, Uta Hill, Mike Harrison, Christopher Johnson, Nicholas Screaton, Charles Haworth, Eva Polverino, Edmundo Rosales, Antoni TorresMichael N. Benegas, Adriano G. Rossi, Dilip Patel, Adam T. Hill

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objectives: The goal of this study was to develop a simplified radiological score that could assess clinical disease severity in bronchiectasis. Methods: The Bronchiectasis Radiologically Indexed CT Score (BRICS) was devised based on a multivariable analysis of the Bhalla score and its ability in predicting clinical parameters of severity. The score was then externally validated in six centers in 302 patients. Results: A total of 184 high-resolution CT scans were scored for the validation cohort. In a multiple logistic regression model, disease severity markers significantly associated with the Bhalla score were percent predicted FEV1, sputum purulence, and exacerbations requiring hospital admission. Components of the Bhalla score that were significantly associated with the disease severity markers were bronchial dilatation and number of bronchopulmonary segments with emphysema. The BRICS was developed with these two parameters. The receiver operating-characteristic curve values for BRICS in the derivation cohort were 0.79 for percent predicted FEV1, 0.71 for sputum purulence, and 0.75 for hospital admissions per year; these values were 0.81, 0.70, and 0.70, respectively, in the validation cohort. Sputum free neutrophil elastase activity was significantly elevated in the group with emphysema on CT imaging. Conclusions: A simplified CT scoring system can be used as an adjunct to clinical parameters to predict disease severity in patients with idiopathic and postinfective bronchiectasis.

Original languageEnglish
Pages (from-to)1177-1186
Number of pages10
JournalChest
Volume153
Issue number5
DOIs
Publication statusPublished - May 1 2018

Fingerprint

Bronchiectasis
Multicenter Studies
Sputum
Emphysema
Logistic Models
Leukocyte Elastase
ROC Curve
Dilatation

Keywords

  • bronchiectasis
  • CT scan
  • scoring system

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Bedi, P., Chalmers, J. D., Goeminne, P. C., Mai, C., Saravanamuthu, P., Velu, P. P., ... Hill, A. T. (2018). The BRICS (Bronchiectasis Radiologically Indexed CT Score): A Multicenter Study Score for Use in Idiopathic and Postinfective Bronchiectasis. Chest, 153(5), 1177-1186. https://doi.org/10.1016/j.chest.2017.11.033

The BRICS (Bronchiectasis Radiologically Indexed CT Score) : A Multicenter Study Score for Use in Idiopathic and Postinfective Bronchiectasis. / Bedi, Pallavi; Chalmers, James D.; Goeminne, Pieter C.; Mai, Cindy; Saravanamuthu, Pira; Velu, Prasad Palani; Cartlidge, Manjit K.; Loebinger, Michael R.; Jacob, Joe; Kamal, Faisal; Schembri, Nicola; Aliberti, Stefano; Hill, Uta; Harrison, Mike; Johnson, Christopher; Screaton, Nicholas; Haworth, Charles; Polverino, Eva; Rosales, Edmundo; Torres, Antoni; Benegas, Michael N.; Rossi, Adriano G.; Patel, Dilip; Hill, Adam T.

In: Chest, Vol. 153, No. 5, 01.05.2018, p. 1177-1186.

Research output: Contribution to journalArticle

Bedi, P, Chalmers, JD, Goeminne, PC, Mai, C, Saravanamuthu, P, Velu, PP, Cartlidge, MK, Loebinger, MR, Jacob, J, Kamal, F, Schembri, N, Aliberti, S, Hill, U, Harrison, M, Johnson, C, Screaton, N, Haworth, C, Polverino, E, Rosales, E, Torres, A, Benegas, MN, Rossi, AG, Patel, D & Hill, AT 2018, 'The BRICS (Bronchiectasis Radiologically Indexed CT Score): A Multicenter Study Score for Use in Idiopathic and Postinfective Bronchiectasis', Chest, vol. 153, no. 5, pp. 1177-1186. https://doi.org/10.1016/j.chest.2017.11.033
Bedi, Pallavi ; Chalmers, James D. ; Goeminne, Pieter C. ; Mai, Cindy ; Saravanamuthu, Pira ; Velu, Prasad Palani ; Cartlidge, Manjit K. ; Loebinger, Michael R. ; Jacob, Joe ; Kamal, Faisal ; Schembri, Nicola ; Aliberti, Stefano ; Hill, Uta ; Harrison, Mike ; Johnson, Christopher ; Screaton, Nicholas ; Haworth, Charles ; Polverino, Eva ; Rosales, Edmundo ; Torres, Antoni ; Benegas, Michael N. ; Rossi, Adriano G. ; Patel, Dilip ; Hill, Adam T. / The BRICS (Bronchiectasis Radiologically Indexed CT Score) : A Multicenter Study Score for Use in Idiopathic and Postinfective Bronchiectasis. In: Chest. 2018 ; Vol. 153, No. 5. pp. 1177-1186.
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AU - Bedi, Pallavi

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AU - Goeminne, Pieter C.

AU - Mai, Cindy

AU - Saravanamuthu, Pira

AU - Velu, Prasad Palani

AU - Cartlidge, Manjit K.

AU - Loebinger, Michael R.

AU - Jacob, Joe

AU - Kamal, Faisal

AU - Schembri, Nicola

AU - Aliberti, Stefano

AU - Hill, Uta

AU - Harrison, Mike

AU - Johnson, Christopher

AU - Screaton, Nicholas

AU - Haworth, Charles

AU - Polverino, Eva

AU - Rosales, Edmundo

AU - Torres, Antoni

AU - Benegas, Michael N.

AU - Rossi, Adriano G.

AU - Patel, Dilip

AU - Hill, Adam T.

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N2 - Objectives: The goal of this study was to develop a simplified radiological score that could assess clinical disease severity in bronchiectasis. Methods: The Bronchiectasis Radiologically Indexed CT Score (BRICS) was devised based on a multivariable analysis of the Bhalla score and its ability in predicting clinical parameters of severity. The score was then externally validated in six centers in 302 patients. Results: A total of 184 high-resolution CT scans were scored for the validation cohort. In a multiple logistic regression model, disease severity markers significantly associated with the Bhalla score were percent predicted FEV1, sputum purulence, and exacerbations requiring hospital admission. Components of the Bhalla score that were significantly associated with the disease severity markers were bronchial dilatation and number of bronchopulmonary segments with emphysema. The BRICS was developed with these two parameters. The receiver operating-characteristic curve values for BRICS in the derivation cohort were 0.79 for percent predicted FEV1, 0.71 for sputum purulence, and 0.75 for hospital admissions per year; these values were 0.81, 0.70, and 0.70, respectively, in the validation cohort. Sputum free neutrophil elastase activity was significantly elevated in the group with emphysema on CT imaging. Conclusions: A simplified CT scoring system can be used as an adjunct to clinical parameters to predict disease severity in patients with idiopathic and postinfective bronchiectasis.

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