Prognostic Factors for Exacerbations and Hospitalization in Post-Tuberculosis Bronchiectasis: A Systematic Review

Post-tuberculosis bronchiectasis is an important manifestation of post-tuberculosis lung disease and may lead to recurrent exacerbations and hospitalization. However, evidence regarding prognostic factors associated with these outcomes has not been systematically synthesized. This review evaluated prognostic factors and severity scores associated with subsequent exacerbations and hospitalization among adults with post-tuberculosis bronchiectasis. PubMed, Scopus, ScienceDirect, and ProQuest were searched from inception to 1 September 2026. Longitudinal studies evaluating baseline prognostic factors or validated severity scores for subsequent exacerbation, hospitalization, or readmission among adults with radiologically confirmed post-tuberculosis bronchiectasis were eligible for inclusion. Study selection, data extraction, and risk-of-bias assessment were independently conducted by reviewers. Risk of bias was assessed using the Quality In Prognosis Studies (QUIPS) tool. A random-effects meta-analysis was planned when at least two studies reported sufficiently comparable estimates.The searches identified 462 records. After removal of 128 duplicates, 334 records were screened, 37 reports underwent full-text eligibility assessment, and four independent studies comprising 500 participants were included. Two studies were available only in abstract form. Meta-analysis was not performed due to heterogeneity in prognostic factors, outcome definitions, follow-up durations, effect measures, and variance reporting. Evidence regarding prognostic factors in post-tuberculosis bronchiectasis remains limited and heterogeneous. The performance of the Bronchiectasis Severity Index (BSI) and FACED score varied substantially across cohorts, while reduced forced expiratory volume in one second (FEV₁) and Gram-negative bacterial isolation emerged as potential predictors of exacerbation based on findings from a single study. Prospective multicenter studies using standardized outcomes and comprehensive prognostic model reporting are required before reliable risk stratification can be implemented.