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Predicting COPD-Related Mortality in the Elderly

Predicting COPD-Related Mortality in the Elderly

About 10 years ago, researchers validated the BODE index—which stands for BMI, airflow obstruction, dyspnea, and exercise capacity—as a prognostic mortality risk tool for patients with COPD (Table 1). “The development and validation of the BODE index was an effort to more fully characterize disease severity in patients with COPD,” explains Melissa H. Roberts, MS, PhD. “It captures not only the clinical measurements of COPD through a lung function test, but also some of the systemic effects of the disease that can appear in patients with COPD.” Since 2004, many studies have demonstrated that the BODE index is a more accurate predictor of mortality among patients with COPD than lung function alone. Additional analyses have shown that the index can also serve as a good predictor of severe COPD exacerbations resulting in hospitalization. Over this same stretch of time, other studies have assessed modified versions of the BODE index to determine if other measurements may offer additional value, but these analyses have had mixed results. A Simpler Approach Although the BODE index has proven to be useful, research has suggested that implementing use of the tool can be challenging, oftentimes proving to be impractical if patients are debilitated. Recently, Dr. Roberts and colleagues examined a simplified, quasi-BODE index and published their results in the American Journal of Epidemiology. “The spirometry test for measuring FEV1 to determine airway obstruction and the 6-minute walk test for measuring exercise capacity are not always easy to obtain, especially in patients who are not ambulatory,” explains Dr. Roberts. “A substantial percentage of patients are unable to complete either or both of these tests. In...
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