Juan P de Torres1, Ciro Casanova2, Jose M Marín3, Victor Pinto-Plata4, Miguel Divo4, Javier J Zulueta1, Juan Berto1, Jorge Zagaceta1, Pablo Sanchez-Salcedo1, Carlos Cabrera4, Santiago Carrizo3, Claudia Cote5, Bartolome R Celli6. 1. Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain. 2. Pulmonary Department, Hospital Ntra Sra de Candelaria, Tenerife, Spain Respiratory Research Unit, Hospital Ntra Sra de Candelaria, Tenerife, Spain. 3. Pulmonary Department, Hospital Universitario Miguel Servet, Zaragoza, Spain. 4. Pulmonary Department, Hospital Universitario Dr Negrin, Las Palmas, Spain. 5. Pulmonary Department, Bay Pines VA Medical Center, St Petersburg, Florida, USA. 6. Pulmonary Department, Brigham and Women's Hospital. Harvard Medical School Boston, Boston Massachusetts, USA.
Abstract
BACKGROUND: The Global Obstructive Lung Disease (GOLD) 2011 revision recommends the multidimensional assessment of COPD including comorbidities and has developed a disease categories system (ABCD) attempting to implement this strategy. The added value provided by quantifying comorbidities and integrating them to multidimensional indices has not been explored. OBJECTIVE: Compare the prognostic value of the GOLD ABCD categories versus the BMI, Obstruction, Dyspnea, Exercise (BODE) index, and explore the added prognostic value of comorbidities evaluation to this multidimensional assessment. METHODS: From the patients who have been enrolled in the BODE study, we selected the most recent ones who had the available information needed to classify them by the ABCD GOLD categories. Cox proportional hazards ratios for all-cause mortality were performed for GOLD categories and BODE index. The added value of the comorbidity Copd cO-morbidity TEst (COTE) index was also explored using receiver operating curves (ROC) values. RESULTS: 707 patients were followed for 50±30 months including all degrees of airway limitation and BODE index severity. ABCD GOLD predicted global mortality (HR: 1.47; 95% CI 1.28 to 1.70) as did the BODE index (HR: 2.02; 95% CI 1.76 to 2.31). Area under the curve (AUC) of ROC for ABCD GOLD was 0.68; (95% CI 0.64 to 0.73) while for the BODE index was 0.71 (95% CI 0.67 to 0.76). The C statistics value was significantly higher for the observed difference. Adding the COTE index to the BODE index improved its AUC to 0.81 (95% CI 0.77 to 0.85), (χ(2)=40.28, p<0.001). CONCLUSIONS: In this population of COPD patients, the BODE index had a better survival prediction than the ABCD GOLD categories. Adding the COTE to the BODE index was complimentary and significantly improved outcome prediction. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND: The Global Obstructive Lung Disease (GOLD) 2011 revision recommends the multidimensional assessment of COPD including comorbidities and has developed a disease categories system (ABCD) attempting to implement this strategy. The added value provided by quantifying comorbidities and integrating them to multidimensional indices has not been explored. OBJECTIVE: Compare the prognostic value of the GOLD ABCD categories versus the BMI, Obstruction, Dyspnea, Exercise (BODE) index, and explore the added prognostic value of comorbidities evaluation to this multidimensional assessment. METHODS: From the patients who have been enrolled in the BODE study, we selected the most recent ones who had the available information needed to classify them by the ABCD GOLD categories. Cox proportional hazards ratios for all-cause mortality were performed for GOLD categories and BODE index. The added value of the comorbidity Copd cO-morbidity TEst (COTE) index was also explored using receiver operating curves (ROC) values. RESULTS: 707 patients were followed for 50±30 months including all degrees of airway limitation and BODE index severity. ABCD GOLD predicted global mortality (HR: 1.47; 95% CI 1.28 to 1.70) as did the BODE index (HR: 2.02; 95% CI 1.76 to 2.31). Area under the curve (AUC) of ROC for ABCD GOLD was 0.68; (95% CI 0.64 to 0.73) while for the BODE index was 0.71 (95% CI 0.67 to 0.76). The C statistics value was significantly higher for the observed difference. Adding the COTE index to the BODE index improved its AUC to 0.81 (95% CI 0.77 to 0.85), (χ(2)=40.28, p<0.001). CONCLUSIONS: In this population of COPDpatients, the BODE index had a better survival prediction than the ABCD GOLD categories. Adding the COTE to the BODE index was complimentary and significantly improved outcome prediction. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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: Janine A M Westerik; Esther I Metting; Job F M van Boven; Waling Tiersma; Janwillem W H Kocks; Tjard R Schermer Journal: Respir Res Date: 2017-02-06
Authors: Kristian Brat; Marek Plutinsky; Karel Hejduk; Michal Svoboda; Patrice Popelkova; Jaromir Zatloukal; Eva Volakova; Miroslava Fecaninova; Lucie Heribanova; Vladimir Koblizek Journal: Int J Chron Obstruct Pulmon Dis Date: 2018-03-26
Authors: Douglas W Mapel; Anand A Dalal; Phaedra T Johnson; Laura K Becker; Alyssa Goolsby Hunter Journal: Int J Chron Obstruct Pulmon Dis Date: 2015-07-30
Authors: Juan P de-Torres; Ana Ezponda; Ana B Alcaide; Arantza Campo; Juan Berto; Jessica Gonzalez; Javier J Zulueta; Ciro Casanova; Luisa Elena Rodriguez-Delgado; Bartolome R Celli; Gorka Bastarrika Journal: PLoS One Date: 2018-04-25 Impact factor: 3.240