Source: Annual Congress 2009 - Prognosis and comorbidities in COPD
Disease area: Airway diseases

Abstract

Introduction: This study assessed the relationship between serial changes in BODE index (a multidimensional grading index including Body mass index, Obstruction of the airway [FEV₁], Dyspnoea score [modified Medical Research Council {mMRC} questionnaire and Exercise capacity [6 min walk test]) and mortality and readmissions of COPD patients.
Method: A prospective cohort study involving 307 (256 males) COPD patients (recruited during their admissions for acute exacerbations COPD [AECOPD]). Assessment of the BODE index was performed at 6 weeks(baseline), 6 months, 12 months, 18 months and 24 months post hospital discharge. Mortality and readmissions in the subsequent 3 years were recorded. All the patients were managed by usual care with no specific intervention.
Results: The mean(SD) age, FEV₁ % predicted were 75.2(8.0)yrs, and 49.3(21.8) respectively. Over the 3 years, 31.6% died whereas 77.2% had at least 1 readmission for AECOPD. Baseline BODE index was predictive of both the survival and readmissions to hospital for AECOPD by Cox regression analysis (p<0.001 for both survival and readmissions). Patients with higher BODE scores were at higher risk for death; the hazard ratio for death from any cause per one-point increase in the BODE score was 1.30 (95% CI, 1.21-1.41; P<0.001). With usual care, 74(24.1%), 116(37.8%), 17 (5.5%) patients had increase (>1point), no change, and decrease in BODE (>1point) index over 24 months respectively. Serial changes in BODE index were not associated with both mortality and readmissions.
Conclusion: Baseline BODE index could predict both survival and readmissions for AECOPD, whereas serial BODE index could not.

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Citations should be made in the following way:
F. W. S. Ko, J. Ngai, A. Tung, S. S. Ng, K. Lai, D. Hui (Hong Kong, Hong Kong). A longitudinal study of the relationship between serial changes in BODE index, mortality and readmissions in patients with COPD. Eur Respir J 2009; 34: Suppl. 53, 502

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