Source: Annual Congress 2008 - Lung and bone marrow transplantation: miscellaneous
Disease area: Airway diseases

Abstract

Background:The BODE index predicts 4yr mortality in patients with COPD. It is used to trigger referral for lung transplantation and informs the decision to refer and list for transplantation (ISHLT Guidelines–2006 update). It was hypothesised that this over-estimates predicted mortality in those referred for lung transplantation.
Aim:To describe patients with COPD referred for lung transplantation and determine actual and predicted mortality with reference to the BODE index.
Method:Patients with COPD undergoing lung transplant assessment from 1998-2000 had physiological information and BODE scores extracted(n=68) with retrospective note review. Six patients were excluded due to either significant life limiting co-morbidites, as in the NEJM 2004 paper, or problems with data collection.
Results:Median age was 51 years(38-61). BMI was 21.2(14.4-33.6). FEV1 %pred was 19%(9-54). 6 Minute Walk Test was 161m(10-450). MMRC dyspnoea score was 3(1-4). The median extracted BODE score was 8(4-10)
Survival(yr) in each group was: Group 1 (BODE 3-6) median survival 8yr (n=14), Group 2 (BODE 7+) (n=48) median: 3.75yr(0.19-8.45).

Conclusions:Survival in this selected group of patients referred for transplantation with a BODE score of 7+ was 72% and 45% at 2 and 4yr respectively and greater than that reported for the general COPD population. This questions the value of using this index as a guide to transplant listing of patients with COPD.

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Citations should be made in the following way:
A. McDiarmid, A. De Soyza, G. Parry, J. Lordan, A. Fisher, P. A. Corris (Newcastle-upon-Tyne, United Kingdom). Does the BODE index predict survival in patients suitable for lung transplantation?. Eur Respir J 2008; 32: Suppl. 52, 1623

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