Pan-European validation of the Bronchiectasis Health Questionnaire: data from the EMBARC-BRIDGE study

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Introduction: The Bronchiectasis Health Questionnaire (BHQ) is a simple, easy to use patient-reported outcome measure in patients with bronchiectasis, with a total score. This study examined the BHQ and its relationship with clinical measures in a multicentre European cohort. Methods: The EMBARC-BRIDGE study is a pan-European cohort of patients with computed tomography (CT) confirmed bronchiectasis from 11 countries embedded within the European bronchiectasis registry. The BHQ was performed at baseline and annual follow-up. The relationship with future exacerbations was analysed using negative binomial regression. Results: 1102 patients were included and 937 patients with baseline BHQ scores were analysed. BHQ was highly correlated with the Quality of Life Bronchiectasis (QOL-B) respiratory symptom score (r=0.78, p<0.0001). BHQ scores were significantly correlated with Bronchiectasis Severity Index (BSI), FEV1, Medical Research Council (MRC) dyspnoea score, prior exacerbations; all p<0.0001. BHQ was also related to future outcomes. Each 10 point decrease in the BHQ score was associated with a 30% increased risk of exacerbations (rate ratio (RR) 1.30, 95%CI 1.20-1.41, p<0.0001) and a marked increased risk of severe exacerbations requiring hospitalisation (RR 2.20, 95%CI 1.71-2.85, p<0.0001). Conclusion: The BHQ is highly correlated with established measures of bronchiectasis disease burden and is strongly predictive of future exacerbations and hospitalisation.

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