Factors associated with radiologic progression of non‐cystic fibrosis bronchiectasis during long‐term follow‐up

Abstract

Background and objective: Non-cystic fibrosis (CF) bronchiectasis is a chronic airway inflammatory disease, exhibiting a diverse array of clinical courses. The purpose of this study was to determine the factors that predict radiologic progression of non-CF bronchiectasis during a long-term follow-up. Methods: We reviewed the electronic medical records that included pulmonary function test data from non-CF bronchiectasis patients, who were older than 18 years of age with a follow-up of computerized tomography for more than 5 years. The original Bhalla score was used to determine the radiologic severity of non-CF bronchiectasis. Results: A total of 155 patients (mean age, 59.6 years; male, 45.2%) were included for the final analysis. The mean follow up time was 7.11 ± 1.42 (5-10) years. The baseline Bhalla score was 9.52 ± 3.14 (4-19), and the change of Bhalla score was 0.55 ± 1.14 (À2 to 5). The Bhalla score was increased in 56 patients (36.1%) but not in 99 patients (63.9%). The Bhalla score change was significantly associated with the age at diagnosis (p = 0.037), body mass index (BMI, p = 0.012), chronic infection of Pseudomonas aeruginosa (p = 0.005) or isolation of nontuberculous mycobacterium (p = 0.042) in respiratory specimens. In a multivariate analysis, BMI and isolation of P. aeruginosa were significantly related with the Bhalla score change. Conclusion: The radiologic progression of non-CF bronchiectasis was associated with lower BMI and isolation of P. aeruginosa in respiratory specimens.

Etiology and characteristics of patients with bronchiectasis in Taiwan: a cohort study from 2002 to 2016

“…P. aeruginosa and H. influenza were the major pathogens in the postinfection and COPD groups, whereas NTM was the most common pathogen in post-tuberculosis group. Several groups have reported variable prevalence of NTM infection in Asia (2-4% in southern China and 44.5% in South Korea) [4,43]. The specific microbiology spectrum of different etiologies has been reported in an Indian population cohort, in which post-infection, post-tuberculosis and idiopathic groups grew more species of cultured bacteria and P. aeruginosa, Enterobacteriaceae species and S. aureus were the most common pathogens, while NTM was uncommon in the cohort [14].…”

Geographic variation in the aetiology, epidemiology and microbiology of bronchiectasis

“…South Korea has a different distribution with high NTM (44.5%), similar to that of the US and lower rates of P. aeruginosa (18.1%). Like the Thai patients, South Koreans also had a significant prevalence of K. pneumoniae [97]. While geographically close; work from Japan however reports P. aeruginosa as the predominant airway bacteria (24%) closely followed by only moderate levels of NTM (19%) [37].…”

Is it feasible to radiologically monitor the evolution of non‐CF bronchiectasis? ‐ Reply

“…We agree that further studies are needed to validate the Bhalla score in non‐cystic fibrosis (CF) patients. In our study, about one‐third of the study population showed radiological deterioration of bronchiectasis with the Bhalla score system . Although an overall change of the Bhalla score from 9.5 to 10.1 points might not be considered significant by some, the increase in the score in the radiological deterioration group might have radiological importance.…”