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

Abstract

Abstract Background Bronchiectasis is characterised by chronic airway inflammation associated with several inflammatory biomarkers. Fibrinogen is an acute-phase reactant and may represent a biomarker of bronchiectasis. Objective To evaluate the serum fibrinogen level as a biomarker in stable non-cystic fibrosis bronchiectasis and to determine its association with the disease severity. Methods This prospective cross-sectional study recruited 65 cases diagnosed with stable non-cystic fibrosis bronchiectasis. The bronchiectasis severity index (BSI) or F: FEV1%, A: age, C: colonization, E: radiological extent of disease, and D: dyspnea (FACED) scores were assessed, and the serum fibrinogen level was measured for all patients studied. Results Patients with bronchiectasis had high plasma fibrinogen level (the mean level was 432.17 ± 63.3), and the serum fibrinogen level was significantly increased with increasing severity of BSI & FACED scores about 37 (56.9%) cases experienced ≥3 follow up exacerbation, the high level of serum fibrinogen and frequency of previous exacerbation were significant factors that associated with the occurrence of follow up exacerbation. The optimal cut off point serum fibrinogen which predict the occurrence of high frequent exacerbation was 416.5 mg/dl (P <0.001). There was a significant positive correlation between BSI & FACED scores and white blood cell (WBC) count, ESR, and serum fibrinogen level. The high serum fibrinogen level, ex-smokers, and WBC count were independent variables associated with the BSI score (P < 0.001, P = 0.02, and P = 0.048, respectively). Conclusion The higher level of serum fibrinogen in patients with stable non-cystic fibrosis bronchiectasis was associated with higher disease severity and can be used as a good predictor of exacerbation.