Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Mar 16;19(1):43.
doi: 10.1186/s12931-018-0746-7.

Factors associated with bronchiectasis in patients with uncontrolled asthma; the NOPES score: a study in 398 patients

A Padilla-Galo  1 , C Olveira  2 , L Fernández de Rota-Garcia  1 , I Marco-Galve  3 , A J Plata  4 , A Alvarez  3 , F Rivas-Ruiz  5 , A Carmona-Olveira  6 , J J Cebrian-Gallardo  1 , M A Martinez-Garcia  7
Affiliations

Factors associated with bronchiectasis in patients with uncontrolled asthma; the NOPES score: a study in 398 patients

A Padilla-Galo et al. Respir Res. .

Abstract

Background: Some studies have reported a high prevalence of bronchiectasis in patients with uncontrolled asthma, but the factors associated with this condition are unknown. The objective of this study was to determine the prevalence of bronchiectasis in uncontrolled moderate-to-severe asthma and to identify risk factors and their correlation with bronchiectasis in these patients.

Methods: This is a prospective study of data from consecutive patients with uncontrolled moderate-to-severe asthma. Diagnosis of bronchiectasis was based on high-resolution computed tomography. A prognostic score was developed using a logistic regression model, which was used to determine the factors associated with bronchiectasis.

Results: A total of 398 patients (60% with severe asthma) were included. The prevalence of bronchiectasis was 28.4%. The presence of bronchiectasis was associated with a higher frequency of chronic expectoration (OR, 2.95; 95% CI, 1.49-5.84; p = 0.002), greater severity of asthma (OR, 2.43; 95% CI, 1.29-4.57; p = 0.006), at least one previous episode of pneumonia (OR, 2.42; 95% CI, 1.03-5.69; p = 0.044), and lower levels of FeNO (OR, 0.98; 95% CI, 0.97-0.99; p = 0.016). The NOPES score was developed on the basis of these variables (FeNO[cut off point 20.5 ppb], Pneumonia, Expectoration and asthma Severity), and it ranges from 0 to 4 points, where 0 means "no risk" and 4 corresponds to "high risk". The NOPES score yielded an AUC-ROC of 70% for the diagnosis of bronchiectasis, with a specificity of 95%.

Conclusions: Almost a third of the patients with uncontrolled moderate-to-severe asthma had bronchiectasis. Bronchiectasis was related to the severity of asthma, the presence of chronic expectoration, a previous history of pneumonia, and lower levels of FeNO. The NOPES score is an easy-to-use scoring system with a high prognostic value for bronchiectasis in patients with uncontrolled moderate-to-severe asthma.

Keywords: Asthma; Bronchiectasis; NOPES; Prevalence; Risk factors.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Written informed consent was obtained from all participants. The study was approved by our hospital’s Ethics Committee (approval:008_OCT_PI2_bronquiectasias).

Consent for publication

Not applicable.

Competing interests

The authors have reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Protocol for the management of uncontrolled asthma in the Hospital Costa del Sol
Fig. 2
Fig. 2
Flow diagram
Fig. 3
Fig. 3
a Probability of bronchiectasis in patients with uncontrolled moderate-to-severe asthma and FeNO levels > 20.5 ppb. b Probability of bronchiectasis in patients with uncontrolled moderate-to-severe asthma with FeNO levels ≤20.5 ppb
Fig. 4
Fig. 4
ROC curve for the NOPES score
Fig. 5
Fig. 5
Probability of bronchiectasis in patients with uncontrolled moderate-to-severe asthma, according to the NOPES score
See this image and copyright information in PMC

References

    1. Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA), 2016. http://www.ginasthma.org/.
    1. Bousquet J, Clark TJH, Hurd S, Khaltaev N, Lenfant C, O'byrne P, et al. GINA guidelines on asthma and beyond. Allergy. 2007;62(2):102–112. doi: 10.1111/j.1398-9995.2006.01305.x. - DOI - PubMed
    1. Martínez-García MÁ, Máiz L, Olveira C, Girón RM, de la Rosa D, Blanco M, et al. Spanish guidelines on the evaluation and diagnosis of bronchiectasis in adults. Arch Bronconeumol. 2017;(17):30272–7. 10.1016/j.arbres.2017.07.015. - PubMed
    1. Seitz AE, Olivier KN, Adjemian J, Holland SM, Prevots R. Trends in bronchiectasis among Medicare beneficiaries in the United States, 2000 to 2007. Chest. 2012;142:432–439. doi: 10.1378/chest.11-2209. - DOI - PMC - PubMed
    1. Martínez-García MA, Máiz-Carro L, Catalán-Serra P. Tratamiento de las bronquiectasias no debidas a fibrosis quística. Arch Bronconeumol. 2011;47(12):599–609. doi: 10.1016/j.arbres.2011.06.003. - DOI - PubMed

Publication types