Bronchiectasis Severity Index (BSI) Calculator

BSI is a clinical predictive tool that identifies patients at risk of future mortality, hospitalization, and exacerbations.

Read more about the criteria involved and the 1 and 4-year outcomes in the text below the tool.


This BSI score calculator uses independent predictors of hospitalisation and mortality to stratify bronchiectasis severity, 1 and 4 year mortality and hospitalisation rates.

It has been derived and validated by Chalmers et al. in 2014 following a study on a UK cohort  of 608 patients (derivation) and independent UK, Belgium and Italy cohorts totalling 702 patients (validation).


BSI Interpretation

0- 4 Mild Bronchiectasis
1 year outcomes: 0 – 2.8 % mortality rate, 0 – 3.4 % hospitalisation rate
4 year outcomes: 0 – 5.3 % mortality rate, 0 – 9.2 % hospitalisation rate

5 – 8 Moderate Bronchiectasis
1 year outcomes: 0.8 – 4.8 % mortality rate, 1.0 – 7.2 % hospitalisation rate
4 year outcomes: 4 % – 11.3 % mortality rate, 9.9 – 19.4 % hospitalisation rate

9 + Severe Bronchiectasis
1 year outcomes: 7.6 % – 10.5 % mortality rate, 16.7 – 52.6 % hospitalisation rate
4 year outcomes: 9.9 – 29.2 % mortality, 41.2 – 80.4 % hospitalisation rate


1

Age

2

BMI

If you don't know the BMI, you can calculate it separately here.
3

FEV1 % Predicted

4

Previous Hospital Admission

5

Number of exacerbations in previous year

6

MRC Breathlessness Score

1 - Not troubled by breathlessness except on strenuous exercise
2 - Short of breath when hurrying or walking up a slight hill
3 - Walks slower than contemporaries on level ground because of breathlessness, or has to stop for breath when walking at own pace
4 - Stops due to breathlessness after walking 100m
5 - House bound due to breathlessness, or breathless on dressing or undressing.
7

Pseudomonas Colonisation

Chronic colonisation is defined by the isolation of pseudomonas aeriginosa in sputum culture on 2 or more occasions, at least 3 months apart in a 1 year period.
8

Colonisation with other organisms

Chronic colonisation is defined by the isolation of potentially pathogenic bacteria in sputum culture on 2 or more occasions, at least 3 months apart in a 1 year period.
9

Radiological Severity

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Steps on how to print your input & results:

1. Fill in the calculator/tool with your values and/or your answer choices and press Calculate.

2. Then you can click on the Print button to open a PDF in a separate window with the inputs and results. You can further save the PDF or print it.

Please note that once you have closed the PDF you need to click on the Calculate button before you try opening it again, otherwise the input and/or results may not appear in the pdf.


 

Bronchiectasis Severity Index explained

This BSI calculator can be used to stratify bronchiectasis severity, one and four year mortality and hospitalisation rates. It uses clinical, radiological and microbiological findings to accurately identify patients with non-cystic fibrosis bronchiectasis at high risk of future mortality, hospital admissions, and exacerbations.

Independent predictors of future hospitalization used are:

  • Prior hospital admissions;
  • Medical Research Council dyspnea score greater than or equal to 4;
  • FEV1 < 30% predicted;
  • Pseudomonas aeruginosa colonization;
  • Colonization with other pathogenic organisms;
  • Three or more lobes involved on high-resolution computed tomography.

Independent predictors of mortality are:

  • Older age;
  • Low FEV1;
  • Lower body mass index;
  • Prior hospitalization;
  • Three or more exacerbations in the year before the study.

The BSI was found to give excellent predictions of hospital admissions, exacerbations and quality of life in non-CF bronchiectasis patients. A similar tool is the E-FACED Score which was found to provide a similar assessment of disease severity.

 

About the original study

The BSI has been derived and validated by Chalmers et al. in 2014 following a study on a UK cohort of 608 patients (derivation) and independent UK, Belgium and Italy cohorts totalling 702 patients (validation).

The study excluded patients with active NTM disease and those receiving long-term antibiotic therapy. This score has limitations, as it only takes into account the number of lobes involved and the degree of dilatation.

The derived BSI predicted mortality and hospitalization with the following statistic results for area under the receiver operator characteristic curve:

  • AUC 0.80 (95% confidence interval, 0.74-0.86) for mortality;
  • AUC 0.88 (95% confidence interval, 0.84-0.91) for hospitalization.

In the validation cohorts, area under the receiver operator characteristic curve results were:

  • AUC 0.81-0.84 for mortality;
  • AUC 0.80-0.88 for hospitalization.
 

References

Original reference

Chalmers JD, Goeminne P, Aliberti S, McDonnell MJ, Lonni S, Davidson J, Poppelwell L, Salih W, Pesci A, Dupont LJ, Fardon TC, De Soyza A, Hill AT (2014) The bronchiectasis severity index. An international derivation and validation study. Am J Respir Crit Care Med. Mar 1;189(5):576-85

Other references

Minov J, Karadzinska-Bislimovska J, Vasilevska K, Stoleski S, Mijakoski D. Assessment of the Non-Cystic Fibrosis Bronchiectasis Severity: The FACED Score vs the Bronchiectasis Severity Index. Open Respir Med J. 2015 Mar 31;9:46-51.


Specialty: Pulmonology

System: Respiratory

Objective: Stratification

Type: Index

No. Of Variables: 9

Year Of Study: 2014

Abbreviation: BSI

Article By: Denise Nedea

Published On: March 19, 2024 · 12:00 AM

Last Checked: March 19, 2024

Next Review: March 19, 2029