Severity Assessment

Defining severity of disease and prognosis

In contrast with other respiratory diseases like COPD, pulmonary fibrosis and pneumonia, which have well established disease severity scores, assessment of disease severity is a relatively new concept in bronchiectasis. A combination of clinical, radiological and microbiological features can be used to assess severity, and members of EMBARC recently described a scoring system which has been validated in 1310 patients across 5 European bronchiectasis centres. The bronchiectasis severity index was found to give excellent predictions of mortality and hospital admissions and was also predictive of exacerbations and quality of life, giving a broad assessment of disease severity.


Criteria 0 Points 1 Point 2 Points 3 Points 4 Points 5 Points 6 Points
Age <50 50-69 70-79 80+
BMI kg/m² >=18.5 <18.5
FEV1 % Predicted >80% 50-80% 30-49% <30%
Hospital Admissions in the Past 2 Years No Yes
Exacerbation Frequency in Last 12 Months 0-2 3 or more
MRC Dyspnoea Score 1-3 4 5
Colonisation Status Not colonised Chronic colonisation P. aeruginosa colonisation
Radiological Severity <3 lobes involved 3 or more lobes or cystic changes

Calculation of Final Score

Score Range 1-Year Mortality Rate 1-Year Hospitalisation Rate 4-Year Mortality Rate 4-Year Hospitalisation Rate
0-4 Points 0-2.8% 0-3.4% 0-5.3% 0-9.2%
5-8 Points 0.9-4.8% 1-7.2% 4-11.3% 9.9-19.4%
9+ Points 7.6-10.5% 16.7-52.6% 9.9-29.2% 41.2-80.4%

Bronchiectasis Severity Index Calculator