{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T20:38:39Z","timestamp":1793479119160,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2014,3,1]],"date-time":"2014-03-01T00:00:00Z","timestamp":1393632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>There are no risk stratification tools for morbidity and mortality in bronchiectasis. Identifying patients at risk of exacerbations, hospital admissions, and mortality is vital for future research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study describes the derivation and validation of the Bronchiectasis Severity Index (BSI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Derivation of the BSI used data from a prospective cohort study (Edinburgh, UK, 2008\u20132012) enrolling 608 patients. Cox proportional hazard regression was used to identify independent predictors of mortality and hospitalization over 4-year follow-up. The score was validated in independent cohorts from Dundee, UK (n = 218); Leuven, Belgium (n = 253); Monza, Italy (n = 105); and Newcastle, UK (n = 126).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Independent predictors of future hospitalization were prior hospital admissions, Medical Research Council dyspnea score greater than or equal to 4, FEV1 &amp;lt; 30% predicted, Pseudomonas aeruginosa colonization, colonization with other pathogenic organisms, and three or more lobes involved on high-resolution computed tomography. Independent predictors of mortality were older age, low FEV1, lower body mass index, prior hospitalization, and three or more exacerbations in the year before the study. The derived BSI predicted mortality and hospitalization: area under the receiver operator characteristic curve (AUC) 0.80 (95% confidence interval, 0.74\u20130.86) for mortality and AUC 0.88 (95% confidence interval, 0.84\u20130.91) for hospitalization, respectively. There was a clear difference in exacerbation frequency and quality of life using the St. George\u2019s Respiratory Questionnaire between patients classified as low, intermediate, and high risk by the score (P &amp;lt; 0.0001 for all comparisons). In the validation cohorts, the AUC for mortality ranged from 0.81 to 0.84 and for hospitalization from 0.80 to 0.88.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The BSI is a useful clinical predictive tool that identifies patients at risk of future mortality, hospitalization, and exacerbations across healthcare systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201309-1575oc","type":"journal-article","created":{"date-parts":[[2014,3,1]],"date-time":"2014-03-01T23:24:31Z","timestamp":1393716271000},"page":"576-585","source":"Crossref","is-referenced-by-count":956,"title":["The Bronchiectasis Severity Index. An International Derivation and Validation Study"],"prefix":"10.1093","volume":"189","author":[{"given":"James D.","family":"Chalmers","sequence":"first","affiliation":[{"name":"Tayside Respiratory Research Group, University of Dundee, Dundee, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"Goeminne","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, University Hospital Gasthuisberg, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Aliberti","sequence":"additional","affiliation":[{"name":"Department of Health Science, University of Milan Bicocca, Clinica Pneumologica, AO San Gerardo, Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa J.","family":"McDonnell","sequence":"additional","affiliation":[{"name":"Adult Bronchiectasis Service and Sir William Leech Centre for Lung Research, Freeman Hospital, Newcastle upon Tyne Hospitals, Heaton, Newcastle, United Kingdom"},{"name":"Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Lonni","sequence":"additional","affiliation":[{"name":"Department of Health Science, University of Milan Bicocca, Clinica Pneumologica, AO San Gerardo, Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Davidson","sequence":"additional","affiliation":[{"name":"Adult Bronchiectasis Service and Sir William Leech Centre for Lung Research, Freeman Hospital, Newcastle upon Tyne Hospitals, Heaton, Newcastle, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Poppelwell","sequence":"additional","affiliation":[{"name":"Tayside Respiratory Research Group, University of Dundee, Dundee, United 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Soyza","sequence":"additional","affiliation":[{"name":"Adult Bronchiectasis Service and Sir William Leech Centre for Lung Research, Freeman Hospital, Newcastle upon Tyne Hospitals, Heaton, Newcastle, United Kingdom"},{"name":"Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam T.","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Royal Infirmary of Edinburgh and the University of Edinburgh, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2014,3,1]]},"reference":[{"key":"2026032100334739100_bib1","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.molimm.2012.09.011","article-title":"Mechanisms of immune dysfunction and bacterial persistence in non-cystic fibrosis 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