Single BODE index measurement predicts survival, readmissions in COPD
MedWire News: A single BODE index assessment is enough to predict survival and hospital readmissions over 3 years in patients with chronic obstructive pulmonary disease (COPD), say researchers who found that individual measurements had no such predictive value for mortality.
Previous studies have shown that a single BODE (body mass index, degree of airflow obstruction, dyspnea, and exercise capacity) index measurement predicts mortality in COPD patients better than FEV1 alone, and may predict hospital admissions for COPD exacerbations.
However, "there are currently no data on the ability of serial changes in BODE indices for predicting… mortality and readmissions for COPD patients," explain David Hui (Prince of Wales Hospital, Hong Kong, China) and team.
To address this, the researchers studied 243 patients (208 men) with COPD who were hospitalized for acute exacerbations between 2004 and 2005. The patients were aged an average of 74.2 years and had a mean FEV1 of 51.7% of the predicted value.
All the patients underwent BODE index assessments at 6 weeks, and at 6, 12, 18 and 24 months after hospital discharge.
After 3 years' follow-up, 25.1% (n=61) of the patients had died and 76.5% (n=186) had been readmitted to hospital at least once for a COPD exacerbation.
Using Cox regression analysis, the researchers found that baseline BODE measurement at 6 weeks was predictive of survival and hospital readmission over the 3-year period. Indeed, each one-point increase in baseline BODE index score was associated with 1.25-fold increased risk for death and a 1.12-fold increased risk for hospital readmission.
A change in BODE index score of more than one point between baseline and 6 month assessment was marginally predictive of mortality, but serial changes in BODE index between the other time-points were not predictive of mortality.
However, serial increases in BODE index of at least one point at 6, 12 and 24 months, were predictive of earlier readmissions to hospital.
"A single measurement of BODE index could predict mortality and readmissions of COPD patients over time," Hui and team conclude in the journal Respiratory Medicine.
They add: "Serial measurements of the BODE index six monthly for 2 years were not useful for predicting mortality but appeared to have some predictive effect on readmissions in a group of patients treated with usual care."
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By Mark Cowen