Marjolein Brusse-Keizer1, Maaike Zuur-Telgen2, Job van der Palen3, Paul VanderValk2, Huib Kerstjens4, Wim Boersma5, Francesco Blasi6, Konstantinos Kostikas7, Branislava Milenkovic8, Michael Tamm9, Daiana Stolz9. 1. Medical School Twente, Medisch Spectrum Twente, Enschede, The Netherlands. Electronic address: m.brusse-keizer@mst.nl. 2. Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, The Netherlands. 3. Medical School Twente, Medisch Spectrum Twente, Enschede, The Netherlands; Department of Research Methodology, Measurement, and Data Analysis, University of Twente, Enschede, The Netherlands. 4. University Of Groningen, University Medical Centre Groningen, Department of Pulmonary Medicine, and Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands. 5. Department of Pneumology, Medisch Centrum Alkmaar, Alkmaar, The Netherlands. 6. Department of Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Cà Granda Milan, Italy. 7. Department of Pneumonology, University Thessaly Medical School, Larissa, Greece. 8. Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Pulmonary Diseases, Clinical Center of Serbia, Belgrade, Serbia. 9. Clinic of Pneumology and Respiratory Cell Research, University Hospital Basel, Basel, Switzerland.
Abstract
BACKGROUND: Current multicomponent scores that predict mortality in COPD patients might underestimate the systemic component of COPD. Therefore, we evaluated the accuracy of circulating levels of proadrenomedullin (MR-proADM) alone or combined with the ADO (Age, Dyspnoea, airflow Obstruction), updated ADO or BOD (Body mass index, airflow Obstruction, Dyspnoea) index to predict all-cause mortality in stable COPD patients. METHODS: This study pooled data of 1285 patients from the COMIC and PROMISE-COPD study. RESULTS: Patients with high MR-proADM levels (≥0.87 nmol/l) had a 2.1 fold higher risk of dying than those with lower levels (p < 0.001). Based on the C-statistic, the ADOA index (ADO plus MR-proADM) (C = 0.72) was the most accurate predictor followed by the BODA (BOD plus MR-proADM) (C = 0.71) and the updated ADOA index (updated ADO plus MR-proADM) (C = 0.70). Adding MR-proADM to ADO and BOD was superior in forecasting 1- and 2-year mortality. The net percentages of persons with events correctly reclassified (NRI+) within respectively 1-year and 2-year was 31% and 20% for ADO, 31% and 20% for updated ADO and 25% and 19% for BOD. The net percentages of persons without events correctly reclassified (NRI-) within respectively 1-year and 2-year was 26% and 27% for ADO, 27% and 28% for updated ADO and 34% and 34% for BOD. CONCLUSIONS: Adding MR-proADM increased the predictive power of BOD, ADO and updated ADO index.
BACKGROUND: Current multicomponent scores that predict mortality in COPDpatients might underestimate the systemic component of COPD. Therefore, we evaluated the accuracy of circulating levels of proadrenomedullin (MR-proADM) alone or combined with the ADO (Age, Dyspnoea, airflow Obstruction), updated ADO or BOD (Body mass index, airflow Obstruction, Dyspnoea) index to predict all-cause mortality in stable COPDpatients. METHODS: This study pooled data of 1285 patients from the COMIC and PROMISE-COPD study. RESULTS:Patients with high MR-proADM levels (≥0.87 nmol/l) had a 2.1 fold higher risk of dying than those with lower levels (p < 0.001). Based on the C-statistic, the ADOA index (ADO plus MR-proADM) (C = 0.72) was the most accurate predictor followed by the BODA (BOD plus MR-proADM) (C = 0.71) and the updated ADOA index (updated ADO plus MR-proADM) (C = 0.70). Adding MR-proADM to ADO and BOD was superior in forecasting 1- and 2-year mortality. The net percentages of persons with events correctly reclassified (NRI+) within respectively 1-year and 2-year was 31% and 20% for ADO, 31% and 20% for updated ADO and 25% and 19% for BOD. The net percentages of persons without events correctly reclassified (NRI-) within respectively 1-year and 2-year was 26% and 27% for ADO, 27% and 28% for updated ADO and 34% and 34% for BOD. CONCLUSIONS: Adding MR-proADM increased the predictive power of BOD, ADO and updated ADO index.
Authors: Nina S Godtfredsen; Ditte V Jørgensen; Kristoffer Marsaa; Charlotte S Ulrik; Ove Andersen; Jesper Eugen-Olsen; Line J H Rasmussen Journal: Respir Res Date: 2018-05-21
Authors: Kirsten Koehorst-Ter Huurne; Marjolein Brusse-Keizer; Paul van der Valk; Kris Movig; Job van der Palen; Christina Bode Journal: Patient Prefer Adherence Date: 2018-09-12 Impact factor: 2.711