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Evaluating the serum fibrinogen level as a biomarker of disease severity in stable non-cystic fibrosis bronchiectasis Cover

Evaluating the serum fibrinogen level as a biomarker of disease severity in stable non-cystic fibrosis bronchiectasis

Pneumologia
Volume 73 (2024): Issue 1 (January 2024)
By: ,   and    
Open Access
|Apr 2025
Figures & tables

Figures & Tables

Figure 1.

CS-1600, automated hemostasis analyzer (Sysmex, Wakinohama, Japan).

Table 1.

Baseline demographic and clinical characteristics of the studied patients.

VariableSummary statistics (n = 65) n (%)
Age: Mean ± SD45.83 ± 16.23
Gender:
Female37 (56.9)
Male28 (43.1)
BMI: Mean kg/m2 ± SD22.11 ± 4.39
Smoking:
Non-smokers37 (56.9)
Current13 (20)
Ex-smoker15 (23.1)
Comorbidities:
Yes41 (63.1)
No24 (36.9)
Comorbidities:
Hypertension15 (23.1)
Diabetes Mellitus10 (15.4)
CVD32 (49.2)

1 BMI, body mass index, CVD, cardiovascular disease; SD, standard deviation.

Table 2.

Clinical, laboratory, and radiological parameters of the studied patients.

VariableSummary statistics (n = 65) n (%)
CBC: mean ± SD
WBCs 109/L11.66 ± 5.04
Neutrophils8.88 ± 4.49
Lymphocyte1.54 ± 0.69
Eosinophils0.04 ± 0.07
Platelet317.55 ± 103.87
Haemoglobin12.34 ± 2.07
ESR41.31 ± 20.62
Albumin g/dL3.22 ± 0.49
Fibrinogen mg/dL432.17 ± 63.3
FEV1%55.69 ± 15.63
Respiratory failure
Yes20 (30.8)
No45 (69.2)
Number of affected lobes
0–235 (53.8)
≥330 (46.2)
Radiologic appearance
Cylindrical21 (32.3)
Cystic39 (60)
Varicose5 (7.7)
Pseudomonas colonisation
No33 (50.8)
Yes32 (49.2)
Previous hospital admission
No22 (33.8)
Yes43 (66.2)
Number of follow-up exacerbations
0–228 (43.1)
≥337 (56.9)
MRC dyspnoea scale
0–218 (27.7)
≥347 (72.3)
Number of previous exacerbations
0–226 (40)
≥339 (60)
BSI score: mean ± SD9.29 ± 4.46
Severity of bronchiectasis according to BSI score Mild14 (21.5)
Moderate13 (20)
Severe38 (58.5)
FACED score: mean ± SD3.6 ± 1.75
Severity of bronchiectasis according to FACED score Mild21 (32.3)
Moderate11 (16.9)
Severe33 (50.8)

1 BSI, bronchiectasis severity index; CBC, complete blood count; ESR, Erythrocyte sedimentation rate; FEV1, forced expiratory volume in 1 s; MRC, Medical Research Council; WBCs, white blood cells.

Figure 2.

Cystic bronchiectasis.

Figure 3.

Cylindrical bronchiectasis.

Figure 4.

Relation between serum fibrinogen level and BSI score severity. BSI, bronchiectasis severity index.

Figure 5.

Relation between serum fibrinogen level and FACED score severity.

Table 3.

Correlation between BSI, FACED scores, and laboratory findings

VariableBSI scoreFACED score
Correlation coefficientP-valueCorrelation coefficientP-value
CBC:
WBCs 109/L		r = 0.290.02*r = 0.260.04*
Neutrophilsr = 0.260.04*r = 0.240.051
Lymphocyter = 0.230.06r = 0.090.48
Eosinophilsr = 0.240.06r = 0.10.41
Plateletr = 0.160.21r = 0.240.06
Haemoglobinr = 0.20.11r = 0.110.37
ESRr = 0.340.01*r = 0.320.01*
Albumin g/dLr = –0.160.2r = –0.150.24
Fibrinogen mg/dLr = 0.64<0.001*r = 0.61<0.001*

1* P < 0.05 was statistically significant.

1 BSI, bronchiectasis severity index; CBC, complete blood count; ESR, Erythrocyte sedimentation rate; WBCs, white blood cells.

Table 4.

Univariate and multivariate linear regression analyses of factors associated with BSI and FACED scores

VariableBSI scoreFACED score
Univariate analysisMultivariable analysisUnivariate analysisMultivariable analysis
Unadjusted B (95% CI)P-valueAdjusted B (95% CI)P-valueUnadjusted B (95% CI)P-valueAdjusted B (95% CI)P-value
Age (years)0.06 (–0.01:0.13)0.070.02 (–0.01:0.05)0.17
Smoking
Non-smokers3.24 (0.5:5.97)0.02*–0.35 (–2.78:2.08)0.771.75 (0.72:2.77)0.001*0.6 (–0.41:1.61)0.42
Current3.15 (0.56:5.74)0.02*2.31 (0.33:4.29)0.02*1.32 (0.35:2.3)0.01*1.1 (0.29:1.92)0.01*
Ex-smoker
Comorbidities
Yes–0.59 (–2.9:1.71)0.61–0.2 (–1.11:0.72)0.67
No
CBC: WBCs 109/L0.26 (0.04:0.47)0.02*0.64 (0.01:1.27)0.048*0.09 (0.003:0.17)0.04*0.03 (–0.03:0.11)0.28
Neutrophils0.25 (0.01:0.5)0.04*–0.63 (–1.34:0.08)0.080.1 (0:0.19)0.051
Lymphocyte1.51 (–0.07:3.09)0.060.23 (–0.42:0.87)0.48
Eosinophils16.27 (–0.44:32.98)0.062.84 (–3.97:9.64)0.41
Platelet0.01 (0:0.02)0.210 (0:0.01)0.06
Haemoglobin0.44 (–0.1:0.97)0.110.1 (–0.12:0.31)0.37
ESR0.07 (0.02:0.12)0.01*0.03 (–0.01:0.08)0.130.03 (0.01:0.05)0.01*0.01 (–0.01:0.03)0.39
Albumin g/dL-1.47 (–3.76:0.81)0.2–0.54 (–1.45:0.37)0.24
Fibrinogen mg/dL0.04 (0.03:0.06)<0.001*0.04 (0.03:0.06)<0.001*0.02 (0.01:0.02)<0.001*0.01 (0:01.02)<0.001*

1* p < 0.05 was statistically significant.

1 BSI, bronchiectasis severity index; CBC, complete blood count; CI, Confidence interval; ESR, Erythrocyte sedimentation rate; WBCs, white blood cells.

Table 5.

Univariate and multivariate logistic regression analyses of factors associated with follow-up exacerbation among the studied patients

VariableUnivariate analysisMultivariable analysis
OR (95% CI)P-valueOR (95% CI)P-value
Age (years)1 (0.97:1.03)0.89
BMI kg/m20.97 (0.86:1.08)0.57
Smoking
Non-smokers10.03*10.16
Current6.47 (1.26:33.34)0.3610.17 (0.4:258.41)0.84
Ex-smoker1.77 (0.52:5.97)1.25 (0.14:11.09)
Comorbidities
Yes0.91 (0.33:2.53) 10.86
No1
Fibrinogen mg/dL1.04 (1.02:1.06)< 0.001*1.03 (1.001:1.06)0.046*
FEV1%0.94 (0.9:0.97)0.001*1.01 (0.94:1.1)0.75
Respiratory failure
Yes10.2
No2.01 (0.69:5.85)
Number of affected lobes
0–210.15
≥32.12 (0.77:5.8)
Radiologic appearance
Cylindrical10.02*10.43
Cystic4 (1.3:12.33)0.090.38 (0.03:4.31)0.98
Varicose8 (0.75:85.73)1.06 (0.02:57.05)
Pseudomonas colonisation
No10.001*10.91
Yes6.25 (2.09:18.74)1.13 (0.13:9.97)
Previous hospital admission
No1< 0.001*10.11
Yes14.85 (4.07:54.16)6.14 (0.66:56.8)
MRC dyspnoea scale
0–210.001*10.32
≥38.25 (2.31:29.52)3.85 (0.27:55.13)
Previous exacerbations:
0–21< 0.001*10.04*
≥319.2 (5.38:68.56)6.75 (1.11:41.26)

1* P < 0.05 was statistically significant.

1 BMI, body mass index; CI, Confidence interval; FEV1, forced expiratory volume in 1 s; MRC, Medical Research Council; OR, Odds ratio.

Figure 6.

ROC curve of serum fibrinogen level in predicting the occurrence of high-frequency exacerbations. ROC, receiver operating characteristic.

Table 6.

Cut-off point of serum fibrinogen level in predicting the occurrence of high-frequency exacerbations.

Area under curveP–value95% CICut-off pointSensitivitySpecificity
0.91<0.001*0.84:99416.587%89%

1* P < 0.05 was statistically significant.

1 CI, Confidence interval.

DOI: https://doi.org/10.2478/pneum-2025-0005 | Journal eISSN: 2247-059X | Journal ISSN: 2067-2993
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Language: English, Romanian
Page range: 26 - 35
Published on: Apr 24, 2025
Published by: Romanian Society of Pneumology
In partnership with: Paradigm Publishing Services
Publication frequency: Volume open
Keywords:
serum fibrinogen,
stable non-cystic fibrosis bronchiectasis,
FACED score,
bronchiectasis severity index
Related subjects:
Medicine,
Clinical medicine,
Clinical medicine, other,
Internal medicine,
Pneumology

© 2025 Doaa Gadallah, Ahmed Tawfeek, Shimaa Nour Morsi, published by Romanian Society of Pneumology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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