Prognostic assessment in COPD without lung function: the B-AE-D indices

被引:37
作者
Boeck, Lucas [1 ]
Soriano, Joan B. [2 ]
Brusse-Keizer, Marjolein [3 ]
Blasi, Francesco [4 ]
Kostikas, Konstantinos [5 ]
Boersma, Wim [6 ]
Milenkovic, Branislava [7 ,8 ]
Louis, Renaud [9 ]
Lacoma, Alicia [10 ]
Djamin, Remco [11 ]
Aerts, Joachim [11 ]
Torres, Antoni [12 ]
Rohde, Gernot [13 ]
Welte, Tobias [14 ]
Martinez-Camblor, Pablo [15 ]
Rakic, Janko [1 ]
Scherr, Andreas [1 ]
Koller, Michael [16 ]
van der Palen, Job [3 ]
Marin, Jose M. [17 ,18 ]
Alfageme, Inmaculada [19 ]
Almagro, Pere [20 ]
Casanova, Ciro [21 ]
Esteban, Cristobal [22 ]
Soler-Cataluna, Juan J. [23 ]
de-Torres, Juan P. [24 ]
Miravitlles, Marc [25 ]
Celli, Bartolome R. [26 ]
Tamm, Michael [1 ]
Stolz, Daiana [1 ]
机构
[1] Univ Hosp, Clin Resp Med & Pulm Cell Res, Petersgraben 4, CH-4031 Basel, Switzerland
[2] Univ Autonoma Madrid, Inst Invest Hosp Univ Princesa IISP, Madrid, Spain
[3] Med Spectrum Twente, Med Sch Twente, Enschede, Netherlands
[4] Univ Milan, IRCCS Fdn Osped Maggiore Policlin Ca Granda, Dept Pathophysiol & Transplantat, Milan, Italy
[5] Univ Thessaly, Sch Med, Larisa, Greece
[6] Med Ctr, Dept Pneumol, Alkmaar, Netherlands
[7] Univ Belgrade, Fac Med, Belgrade, Serbia
[8] Clin Ctr Serbia, Clin Pulm Dis, Belgrade, Serbia
[9] Univ Liege, Dept Pneumol, Liege, Belgium
[10] Hosp Badalona Germans Trias & Pujol, CIBER Enfermedades Resp, Dept Microbiol, Badalona, Spain
[11] Amphia Hosp, Dept Pneumol, Breda, Netherlands
[12] Hosp Clin Barcelona, Dept Pneumol, Barcelona, Spain
[13] Maastricht Univ, Dept Resp Med, Med Ctr, Maastricht, Netherlands
[14] Med Hsch, Dept Pneumol, Hannover, Germany
[15] Univ Autonoma Chile, Santiago, Chile
[16] Univ Basel Hosp, Inst Clin Epidemiol & Biostat, Basel, Switzerland
[17] Hosp Univ Miguel Servet, Resp Dept, Zaragoza, Spain
[18] CIBER Enfermedades Resp, Madrid, Spain
[19] Valme Univ Hosp, Resp Dept, Seville, Spain
[20] Hosp Univ Mutua De Terrassa, Internal Med Unit, Barcelona, Spain
[21] Hosp Nuestra Senora Candelaria, Resp Dept, Santa Cruz De Tenerife, Spain
[22] Hosp Galdakao Usansolo, Resp Dept, Bizkaia, Spain
[23] Hosp Arnau De Vilanova Lliria, Pneumol Dept, Valencia, Spain
[24] Clin Univ Navarra, Resp Dept, Pamplona, Spain
[25] Hosp Univ Vall dHebron, Dept Pneumol, Barcelona, Spain
[26] Harvard Univ, Brigham & Womens Hosp, Pulm & Crit Care Med, Boston, MA 02115 USA
关键词
OBSTRUCTIVE PULMONARY-DISEASE; BODE-INDEX; ACUTE EXACERBATION; RISK-FACTORS; MORTALITY; OUTCOMES; PREDICTION; HOSPITALIZATION; VASOPRESSIN; COPEPTIN;
D O I
10.1183/13993003.01485-2015
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Several composite markers have been proposed for risk assessment in chronic obstructive pulmonary disease (COPD). However, choice of parameters and score complexity restrict clinical applicability. Our aim was to provide and validate a simplified COPD risk index independent of lung function. The PROMISE study (n=530) was used to develop a novel prognostic index. Index performance was assessed regarding 2-year COPD-related mortality and all-cause mortality. External validity was tested in stable and exacerbated COPD patients in the ProCOLD, COCOMICS and COMIC cohorts (total n=2988). Using a mixed clinical and statistical approach, body mass index (B), severe acute exacerbations of COPD frequency (AE), modified Medical Research Council dyspnoea severity (D) and copeptin (C) were identified as the most suitable simplified marker combination. 0, 1 or 2 points were assigned to each parameter and totalled to B-AE-D or B-AE-D-C. It was observed that B-AE-D and B-AE-D-C were at least as good as BODE (body mass index, airflow obstruction, dyspnoea, exercise capacity), ADO (age, dyspnoea, airflow obstruction) and DOSE (dyspnoea, obstruction, smoking, exacerbation) indices for predicting 2-year all-cause mortality (c-statistic: 0.74, 0.77, 0.69, 0.72 and 0.63, respectively; Hosmer-Lemeshow test all p>0.05). Both indices were COPD specific (c-statistic for predicting COPD-related 2-year mortality: 0.87 and 0.89, respectively). External validation of B-AE-D was performed in COCOMICS and COMIC (c-statistic for 1-year all-cause mortality: 0.68 and 0.74; c-statistic for 2-year all-cause mortality: 0.65 and 0.67; Hosmer-Lemeshow test all p>0.05). The B-AE-D index, plus copeptin if available, allows a simple and accurate assessment of COPD-related risk.
引用
收藏
页码:1635 / 1644
页数:10
相关论文
共 49 条
[1]   Characteristics, stability and outcomes of the 2011 GOLD COPD groups in the ECLIPSE cohort [J].
Agusti, Alvar ;
Edwards, Lisa D. ;
Celli, Bartolome ;
MacNee, William ;
Calverley, Peter M. A. ;
Muellerova, Hana ;
Lomas, David A. ;
Wouters, Emiel ;
Bakke, Per ;
Rennard, Steve ;
Crim, Courtney ;
Miller, Bruce E. ;
Coxson, Harvey O. ;
Yates, Julie C. ;
Tal-Singer, Ruth ;
Vestbo, Jorgen .
EUROPEAN RESPIRATORY JOURNAL, 2013, 42 (03) :636-646
[2]  
Alfageme Inmaculada, 2010, Chron Respir Dis, V7, P135, DOI 10.1177/1479972310368692
[3]   Mortality after hospitalization for COPD [J].
Almagro, P ;
Calbo, E ;
de Echagüen, AO ;
Barreiro, B ;
Quintana, S ;
Heredia, JL ;
Garau, J .
CHEST, 2002, 121 (05) :1441-1448
[4]   Recent improvement in long-term survival after a COPD hospitalisation [J].
Almagro, Pere ;
Salvado, M. ;
Garcia-Vidal, C. ;
Rodriguez-Carballeira, M. ;
Delgado, M. ;
Barreiro, B. ;
Heredia, J. L. ;
Soriano, Joan B. .
THORAX, 2010, 65 (04) :298-302
[5]  
[Anonymous], 1999, Obesity: preventing and managing the global epidemic. Report of a WHO consultation on obesity
[6]   Systemic manifestations and comorbidities of COPD [J].
Barnes, P. J. ;
Celli, B. R. .
EUROPEAN RESPIRATORY JOURNAL, 2009, 33 (05) :1165-1185
[7]   Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease [J].
Bestall, JC ;
Paul, EA ;
Garrod, R ;
Garnham, R ;
Jones, PW ;
Wedzicha, JA .
THORAX, 1999, 54 (07) :581-586
[8]   Coming together: the ATS/ERS consensus on clinical pulmonary function testing [J].
Brusasco, V ;
Crapo, R ;
Viegi, G .
EUROPEAN RESPIRATORY JOURNAL, 2005, 26 (01) :1-2
[9]   BODE-index, modified BODE-index and ADO-score in Chronic Obstructive Pulmonary Disease: Relationship with COPD phenotypes and CT lung density changes [J].
Camiciottoli, Gianna ;
Bigazzi, Francesca ;
Bartolucci, Maurizio ;
Cestelli, Lucia ;
Paoletti, Matteo ;
Diciotti, Stefano ;
Cavigli, Edoardo ;
Magni, Chiara ;
Buonasera, Luigi ;
Mascalchi, Mario ;
Pistolesi, Massimo .
COPD-JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, 2012, 9 (03) :297-304
[10]   Inspiratory-to-total lung capacity ratio predicts mortality in patients with chronic obstructive pulmonary disease [J].
Casanova, C ;
Cote, C ;
Torres, JPC ;
Aguirre-Jaime, A ;
Marin, JM ;
Pinto-Plata, V ;
Celli, BR .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2005, 171 (06) :591-597