Lung function (FEV1), and dyspnea are known to worsen during AE of COPD. AE are associated with decreased health related quality of life and with increased mortality. The multidimensional BODE index predicts mortality in COPD patients. The effect of acute exacerbations in disease severity of COPD as measured by BODE, is not known.
We prospectively evaluated 51 patients with COPD (98% male), mean age 67 ± 8 years (range 48 to 85). At baseline we measured: FEV1%, modified medical research dyspnea scale (MMRC), 6 minute walking distance (6MWD) and BMI to establish a BODE score (possible range 0-10). These measurements were repeated in 27 patients during an AE (exacerbator group) and compared to 24 patients who did not exacerbate (non exacerbator group). Measurements were repeated after 6 months in both groups.
As shown in figure 1, the BODE score worsened 48% from baseline and recovered to 78% of the original value at 6 months. These significant changes (p<0.001 by ANOVA) were due to lesser changes in the individual components FEV1%, MMRC, and 6MWD without changes in BMI.
The simple BODE index captures the impact of exacerbations in patients with COPD. The lack of return to the baseline value at 6 months in AE compared to non-exacerbators indicates the contribution of AE to further progression of disease.
The multidimensional BODE index can accurately reflect the changes resulting from the clinical evolution of COPD. Exacerbations result in significant changes in BODE which fail to return to normal after the episode resolves.
C.G. Cote, None.