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 (-2 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.

Keywords: Bhalla score; Pseudomonas aeruginosa; body mass index; bronchiectasis; radiologic progression.