Introduction

The clinical course of bronchiectasis in adults can be predicted by BSI and FACED scores. In children, there is no validated tool to evaluate the disease prognosis.

Our study aimed to determine the predictive factors of bad outcomes in pediatric bronchiectasis.

Methods

A retrospective study was conducted in our pulmonology department including 71 children with bronchiectasis hospitalized between January 2014 and December 2022. We analyzed the factors associated with bad outcomes defined by chronic respiratory failure and/or an exacerbation rate > 2 per year.

Results

The mean age at enrolment was 12.1±5.5 years old, the sex ratio was 1.1. The median follow-up period was 5±2 years. The main identified aetiology was congenital disorders (43%), followed by severe pulmonary infections (21%) and aspiration in 3 cases (4%). No underlying cause was found in 32% of patients. Seventeen children had frequent exacerbation (24%). Two patients were hospitalized in the intensive care unit (3%). Three children had a chronic respiratory failure (4%). The disease course was stable in 69% of the cases. Predictive factors of bad prognosis were: irregular follow-up (p<0.01), congenital disorder (p=0.01), bilateral lesions in CT scan (p=0.03), chronic bronchial infection by Pseudomonas Aeruginosa (p=0.01) and airway obstruction (p=0.01). Multivariable-adjusted odds ratios for irregular follow-up was 1.1 (95%CI 0.5 to 1.3), for congenital disorders was 1.5 (95%CI 0.7 to 2.9) and for chronic bronchial infection by Pseudomonas Aeruginosa was 1.3 (95%CI 1.1 to 1.6).

Conclusion

Pediatric bronchiectasis is a chronic pulmonary disease with significant morbidity. An early diangnosis with a regular follow-up allow disease stabilisation.