BACKGROUND: The Dyspnoea, Obstruction, Smoking, Exacerbation (DOSE) index was designed to assess disease severity and for the clinical management of chronic obstructive pulmonary disease (COPD), but has not been evaluated as a prognostic instrument for mortality in a population including primary care patients. AIMS: The aim of this study was to investigate the associations of the DOSE index with mortality in primary and secondary care COPD patients. METHODS: Information was collected from 1,111 COPD patients aged 34-75 years randomly selected from 70 Swedish primary and secondary care centres. Data were obtained using patient questionnaires and record review and the Swedish Board of Health and Welfare provided mortality data. The study population included 562 patients with data on all DOSE index components. The DOSE index was calculated using the MRC dyspnoea scale, forced expiratory volume in 1 second (FEV₁) as percentage of predicted (FEV₁%pred), smoking status, and exacerbation rate. The exacerbation rate over 6 months prior to record review was used to estimate the annual rate. Cox regression analyses estimated survival with adjustment for age, sex, and heart disease. RESULTS: Over 5 years, 116 patients (20.6%) died. Mortality was higher in patients with DOSE index ≥4 (42.4%) than for lower scores (11.0%) (p<0.0001). Compared with a DOSE index score of 0-3, the hazard ratio for mortality was 3.48 (95% CI 2.32 to 5.22) for a score of 4-5, and was 8.00 (95% CI 4.67 to 13.7) for a score of 6-7. CONCLUSIONS: The DOSE index is associated with mortality in COPD patients in primary and secondary care and can be used to assess prognosis in addition to other clinically relevant issues.
BACKGROUND: The Dyspnoea, Obstruction, Smoking, Exacerbation (DOSE) index was designed to assess disease severity and for the clinical management of chronic obstructive pulmonary disease (COPD), but has not been evaluated as a prognostic instrument for mortality in a population including primary care patients. AIMS: The aim of this study was to investigate the associations of the DOSE index with mortality in primary and secondary care COPDpatients. METHODS: Information was collected from 1,111 COPDpatients aged 34-75 years randomly selected from 70 Swedish primary and secondary care centres. Data were obtained using patient questionnaires and record review and the Swedish Board of Health and Welfare provided mortality data. The study population included 562 patients with data on all DOSE index components. The DOSE index was calculated using the MRC dyspnoea scale, forced expiratory volume in 1 second (FEV₁) as percentage of predicted (FEV₁%pred), smoking status, and exacerbation rate. The exacerbation rate over 6 months prior to record review was used to estimate the annual rate. Cox regression analyses estimated survival with adjustment for age, sex, and heart disease. RESULTS: Over 5 years, 116 patients (20.6%) died. Mortality was higher in patients with DOSE index ≥4 (42.4%) than for lower scores (11.0%) (p<0.0001). Compared with a DOSE index score of 0-3, the hazard ratio for mortality was 3.48 (95% CI 2.32 to 5.22) for a score of 4-5, and was 8.00 (95% CI 4.67 to 13.7) for a score of 6-7. CONCLUSIONS: The DOSE index is associated with mortality in COPDpatients in primary and secondary care and can be used to assess prognosis in addition to other clinically relevant issues.
Authors: Pedro Almagro; Esther Calbo; Anna Ochoa de Echagüen; Bienvenido Barreiro; Salvador Quintana; José L Heredia; Javier Garau Journal: Chest Date: 2002-05 Impact factor: 9.410
Authors: Craig P Hersh; Dawn L DeMeo; Essam Al-Ansari; Vincent J Carey; John J Reilly; Leo C Ginns; Edwin K Silverman Journal: Chest Date: 2004-11 Impact factor: 9.410
Authors: Bartolome R Celli; Claudia G Cote; Jose M Marin; Ciro Casanova; Maria Montes de Oca; Reina A Mendez; Victor Pinto Plata; Howard J Cabral Journal: N Engl J Med Date: 2004-03-04 Impact factor: 91.245
Authors: Ian G Stiell; Jeffrey J Perry; Catherine M Clement; Robert J Brison; Brian H Rowe; Shawn D Aaron; Andrew D McRae; Bjug Borgundvaag; Lisa A Calder; Alan J Forster; Jennifer Brinkhurst; George A Wells Journal: CMAJ Date: 2018-12-03 Impact factor: 8.262
Authors: Thomas Keller; Laura J Spece; Lucas M Donovan; Edmunds Udris; Scott S Coggeshall; Matthew Griffith; Alexander D Bryant; Richard Casaburi; J Allen Cooper; Gerard J Criner; Philip T Diaz; Anne L Fuhlbrigge; Steven E Gay; Richard E Kanner; Fernando J Martinez; Ralph J Panos; David Shade; Alice Sternberg; Thomas Stibolt; James K Stoller; James Tonascia; Robert Wise; Roger D Yusen; David H Au; Laura C Feemster Journal: Chest Date: 2020-04-09 Impact factor: 9.410
Authors: Ian G Stiell; Catherine M Clement; Shawn D Aaron; Brian H Rowe; Jeffrey J Perry; Robert J Brison; Lisa A Calder; Eddy Lang; Bjug Borgundvaag; Alan J Forster; George A Wells Journal: CMAJ Date: 2014-02-18 Impact factor: 8.262
Authors: Rupert C Jones; David Price; Niels H Chavannes; Amanda J Lee; Michael E Hyland; Björn Ställberg; Karin Lisspers; Josefin Sundh; Thys van der Molen; Ioanna Tsiligianni Journal: NPJ Prim Care Respir Med Date: 2016-04-07 Impact factor: 2.871
Authors: Khalid Ansari; Niall Keaney; Andrea Kay; Monica Price; Joan Munby; Andrew Billett; Sharon Haggerty; Ian K Taylor; Hajed Al Otaibi Journal: Ann Thorac Med Date: 2016 Oct-Dec Impact factor: 2.219
Authors: Annemarije L Kruis; Björn Ställberg; Rupert C M Jones; Ioanna G Tsiligianni; Karin Lisspers; Thys van der Molen; Jan Willem H Kocks; Niels H Chavannes Journal: PLoS One Date: 2014-03-05 Impact factor: 3.240