The Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity (BODE) index, a multidimensional grading system, is better than the forced expiratory volume in one second (FEV1) at predicting the risk of death among patients with chronic obstructive pulmonary disease (COPD). We hypothesised that the BODE index would also better predict other outcomes such as hospitalisation for exacerbation of COPD in these patients.
We prospectively evaluated the variables and computed the point values of the BODE index in a cohort of 95 patients with COPD. Using Poisson regression analysis, we analysed the ability of the BODE index to predict the risk of hospital admission for exacerbation of COPD over a six-month period in these patients.
There were 35 patients who required at least one hospital admission. Patients with higher BODE scores were at higher risk of hospitalisation. A significant effect of BODE score on the number of hospital admissions (coefficient = 0.18; 95 percent confidence interval, 0.08 to 0.27; P<0.001) was found. In comparison, there was also a significant but smaller effect of the FEV1 percent predicted on the number of hospital admissions (coefficient =-0.02; 95 percent confidence interval, -0.04 to -0.004; P=0.015). There was no significant effect of the BODE score or the FEV1 percent predicted on the total number of days in the hospital.
The BODE index is better than the FEV1 at predicting the risk of hospitalisation for exacerbation among patients with COPD.
A multidimensional grading system like the BODE index should be used in preference to a physiological variable such as the FEV1 to better categorise and predict outcomes of patients with COPD.
W.F. Chong, None.