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Allergy and Airway |

Prognostic Evaluation of COPD Patients Using BODE Index

Md.Siddiqur Rahman, MBBS
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Bangladesh Medical and Dental Council, Dhaka, Bangladesh


Chest. 2014;146(4_MeetingAbstracts):30A. doi:10.1378/chest.1992644
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Abstract

SESSION TITLE: COPD Diagnosis and Evaluation Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: COPD is a common disease characterized by airflow limitation which is irreversible or partially reversible & usually progressive. The prognosis is inversely related to age & directly related to post bronchodilator FEV1.Weight loss, pulmonoary hypertension & co-morbidities are act as additional factors for poor prognosis. The risk of death in patients with COPD is traditionally graded with the use of the FEV1, but it correlates better with the BODE index. The BODE is a multi-dimensional index which combines four important variables into a single score- (B) Body mass index; (O) airflow obstruction measured by the forced expiratory volume in one second (FEV1); (D) dyspnoea measured by the modified MRC scale; and (E) exercise capacity measured by the 6 minutes walk distance (6MWD). Each variable is graded and a score out of 10 is obtained, with higher scores indicating greater risk. The risk of death from respiratory causes increases by more than 60% for each one point increases in BODE index (Celli et al 2003). We use BODE index in our study.

METHODS: A prospective study during the period of January 2010 to December 2012 was conducted in outpatient. Total 252 patients were included who were COPD patients defined by FEV1 < 80% and FEV1/FVC ratio < 70% measured 20 minutes after the administration of salbutamol. A regular follow-up was given as per study protocol.

RESULTS: Among total 252 patients, mean age was 60.63±10.05, male 188 and female 64; 188 smoker, 64 non smoker all of them were exposed to biomass fuel except 2 who were male. During the study period of 3 years, 40 patients died which comprised 15.87% of study population that was lower than the original study. 24 (60% of death) died from non respiratory causes and 16 (40%) from pulmonary causes (Corpulmonale and Respiratory failure). All patients died from respiratory causes had BODE score points 10.

CONCLUSIONS: (1) A recognizable number of patients suffer from COPD due to exposed of biomass fuel particularly females of Bangladesh. (2) Co-morbidities are accountable for the death of COPD patients in addition to variables in BODE index. (3) The higher the BODE score points, higher the risk of death from respiratory causes.

CLINICAL IMPLICATIONS: COPD is a heterogeneous disease without a simple prognostic trajectory. The BODE index measures functional limitation, nutritional status and symptoms, in addition to airflow obstruction, and is therefore well placed to assess clinical risk and the integrated response to treatment.

DISCLOSURE: The following authors have nothing to disclose: Md.Siddiqur Rahman

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