6533b825fe1ef96bd1281e04

RESEARCH PRODUCT

Validation of Murray sputum purulence scale in the Italian Registry of Bronchiectasis (IRIDE)

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Introduction: Murray sputum colour chart stratifies patients according to the presence of mucous (M), muco-purulent (MP) or purulent (P) sputum, and has not been validated in Bx yet. We aimed to validate this scale across a large Italian cohort of Bx patients. Methods: A secondary analysis of the IRIDE database was conducted including adults with Bx and daily sputum production enrolled across 13 Italian centres between 2014 and 2017. M vs. MP vs. P sputum producers were identified and clinical, functional and microbiological data were collected. Clinical outcomes during a two-year follow up period were evaluated in the Monza and Milan cohorts. A sensitivity analysis excluding COPD patients was conducted. Results: 448 patients were enrolled (65% female, median age 68 years): 45% belonged to Group M, 40% to Group MP and 15% to Group P. Significant differences (M vs. MP vs. P) were detected in terms of rate of chronic infection due to any bacteria (30% vs. 47% vs. 71%, p<0.001), P. aeruginosa (20% vs. 32% vs. 58%, p<0.001) and other bacteria (14% vs 19% vs 25%, p=0.038). Median predicted FEV1 was statistically different among the groups (M:88% vs. MP:77% vs. P:72%, p<0.001) as well as the median Bronchiectasis Severity Index values (M:6 vs. MP:8 vs. P:9, p<0.001). Quality of life was significantly poorer in Group P vs. MP vs. M (QoL-B respiration score: 52 vs. 61 vs. 70, p<0.001). Differences in hospitalization rate (M: 10% vs P: 33%) and 3+ exacerbation/year (M 41% vs P 58%) were detected in follow up. The exclusion of COPD did not affect the results. Conclusion: Murray sputum chart is a valuable tool to assess disease severity and might be useful to predict clinical outcomes in Bx.