BODE-index, modified BODE-index and ADO-score in Chronic Obstructive Pulmonary Disease: Relationship with COPD phenotypes and CT lung density changes

Camiciottoli, Gianna; Bigazzi, Francesca; Bartolucci, Maurizio; Cestelli, Lucia; Paoletti, Matteo; Diciotti, Stefano; Cavigli, Edoardo; Magni, Chiara; Buonasera, Luigi; Mascalchi, Mario

doi:10.3109/15412555.2012.661000

Cited by 20 publications

(16 citation statements)

References 32 publications

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“…reflecting the extent of emphysematous destructive changes. This confirms that dyspnoea perception is related to alveolar surface reduction, as assessed either by CT parameters or diffusing capacity of the lung for carbon monoxide [24,25].…”

Section: Pro-adrenomedullin As An Alternative To the 6mwt For Mortalisupporting

confidence: 69%

“…refraining from the 6MWD and aiming to increase the applicability of COPD grading systems outside of the specialised respiratory medicine settings [23]. Recently, 6MWD has been shown to lack independent association with computed tomography (CT) density data in an unselected COPD population, thus portending that reduction in the distance walked in the 6MWT can be attributed, besides to lung parenchymal destruction caused by COPD itself, also to common comorbidities, such as cardiovascular and musculoskeletal disorders [24]. In this context, the fact that patients with musculoskeletal or neuromuscular disorders preventing walking at study inclusion were excluded from the study might have influenced our results.…”

Section: Pro-adrenomedullin As An Alternative To the 6mwt For Mortalimentioning

confidence: 99%

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Adrenomedullin refines mortality prediction by the BODE index in COPD: the "BODE-A" index

Stolz¹,

Κostikas²,

Blasi³

et al. 2013

European Respiratory Journal

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The BODE (body mass index, airflow obstruction, dyspnoea, exercise capacity) index is wellvalidated for mortality prediction in chronic obstructive pulmonary disease (COPD). Concentrations of plasma pro-adrenomedullin, a surrogate for mature adrenomedullin, independently predicted 2-year mortality among inpatients with COPD exacerbation.We compared accuracy of initial pro-adrenomedullin level, BODE and BODE components, alone or combined, in predicting 1-year or 2-year all-cause mortality in a multicentre, multinational observational cohort with stable, moderate to very severe COPD.Pro-adrenomedullin was significantly associated (p,0.001) with 1-year mortality (4.7%) and 2-year mortality (7.8%) and comparably predictive to BODE regarding both (C statistics 0.691 versus 0.745 and 0.635 versus 0.679, respectively). Relative to using BODE alone, adding pro-adrenomedullin significantly improved 1-year and 2-year mortality prognostication (C statistics 0.750 and 0.818, respectively; both p,0.001). Pro-adrenomedullin plus BOD was more predictive than the original BODE including 6-min walk distance. In multivariable analysis, pro-adrenomedullin (likelihood ratio Chi-squared 13.0, p,0.001), body mass index (8.5, p50.004) and 6-min walk distance (7.5, p50.006) independently foretold 2-year survival, but modified Medical Research Council dyspnoea score (2.2, p50.14) and forced expiratory volume in 1 s % predicted (0.3, p50.60) did not.Pro-adrenomedullin plus BODE better predicts mortality in COPD patients than does BODE alone; proadrenomedullin may substitute for 6-min walk distance in BODE when 6-min walk testing is unavailable. @ERSpublications Pro-adrenomedullin improves BODE prediction of mortality in COPD patients and may substitute for 6-min walk distance http://ow.ly/qV5M3This article has supplementary material available from www.erj.ersjournals.com Clinical trial: This study is registered at www.controlled-trials.com with identifier number ISRCTN99586989.

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Section: Pro-adrenomedullin As An Alternative To the 6mwt For Mortalisupporting

confidence: 69%

Section: Pro-adrenomedullin As An Alternative To the 6mwt For Mortalimentioning

confidence: 99%

Adrenomedullin refines mortality prediction by the BODE index in COPD: the "BODE-A" index

Stolz¹,

Κostikas²,

Blasi³

et al. 2013

European Respiratory Journal

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“…CT densitometry also has strong associations with gas transfer (TLCO) [10,[35][36][37][38][39][40], six minute walk distance (6MWD) [32,36,40,42], BODE score [36,39,[43][44][45] and body composition [37,39,46,47].…”

Section: Emphysemamentioning

confidence: 99%

“…Bronchial wall markers also correlate with functional markers in the form of BODE index [44,45], exercise capacity [32,36] and body composition [46]. Although statistically significant many of these associations tended to be quite weak.…”

Section: Page 34 Of 52 European Respiratory Journalmentioning

confidence: 99%

Present and future utility of computed tomography scanning in the assessment and management of COPD

Ostridge

Wilkinson

2016

Eur Respir J

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likely to have important implications for understanding disease progression and the future management of this condition [2]. There are currently no significant diseasemodifying medications for COPD and there have not been the improvements in outcome seen in other chronic diseases. Other tools are required in addition to spirometry to help explain the heterogeneity and provide further insights into approaches to study and treat COPD. CT has current practical applications in the routine management and investigation of the disease and with the development of novel analysis techniques has the potential to provide further details about the pulmonary and extra-pulmonary manifestations of COPD. Computed Tomography in Current Clinical PractisePrior to the 1970s histological and post mortem studies were required to study structural changes of the lung. The introduction of CT made it possible to visualise the thorax and assess lung structure non-invasively. In COPD CT can identify key morphological features, including emphysema, bronchial wall thickening and gas trapping. These pathologies contribute directly to airflow obstruction and therefore CT has the potential to provide vital insights into the underlying pathophysiological changes of COPD. Despite this, routine CT imaging has not necessarily been widely adopted in clinical practise and its place in the management and investigation of COPD has not been firmly established. The GOLD guidelines do not routinely recommend CT scanning in COPD and only advise that it may be helpful in differential diagnosis or when surgical options are being considered [3]. This general ambivalence is highlighted by a study of attitudes in respiratory physicians and surgeons in the UK where only 32% thought it necessary for patients with severe COPD to have a CT scan [4].There are a number of reasons why the use of CT has not become routine in COPD. One of the most important is the perceived notion that using CT does not alter management, although this is not strictly true. The National Emphysema Treatment Trial (NETT) demonstrated that patients with advanced upper lobe emphysema and limited exercise ability improved after lung volume reduction surgery [5]. There has also been considerable progress and experience in using endobronchial treatments for severe emphysema including coils, valves, sealant and airway bypass. In the correct patients with severe heterogeneous emphysema these treatments can lead to significant improvement in pulmonary physiology and functional capacity [6, 7]. CT imaging can also identify bullous disease, which may be amenable to surgery and bullectomy can lead to improved health status [8]. It therefore seems clear that patients with severe COPD require CT imaging to determine which patients are appropriate for these techniques.CT imaging can also detect concomitant pulmonary pathology in COPD. Bronchiectasis is particularly prevalent, with studies demonstrating 50% of COPD patients having CT evidence of the disease [9][10][11]. When present bronchiectasis is asso...

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“…Recent software developments for CT data analysis have increased the reliability of the measurements of the pathological changes occurring in COPD lungs. In general, there is evidence that quantitative CT data identify the predominant phenotype [18][19][20][21][22] and assess the overall severity [23][24][25][26][27] of COPD with considerable accuracy. However, considering the high prevalence of COPD in the general population, the cost of the examination, and the risks associated with the radiation exposure necessary to obtain a CT scan [28], it is evident that quantitative CT scan data cannot, at present, be obtained in all patients affected by COPD.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary function and sputum characteristics predict computed tomography phenotype and severity of COPD

et al. 2012

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Airway obstruction and parenchymal destruction underlie phenotype and severity in chronic obstructive pulmonary disease (COPD). We aimed to predict, by clinical and pulmonary function data, the predominant type and severity of pathological changes quantitatively assessed by computed tomography (CT).Airway wall thickness (AWT-Pi10) and percentage of lung area with X-ray attenuation values ,-950 HU (%LAA-950) were measured in 100 (learning set) out of 473 COPD outpatients undergoing clinical and functional evaluation. Original CT measurements were translated by principal component analysis onto a plane with the novel coordinates CT1 and CT2, depending on the difference (prevalent mechanism of airflow limitation) and on the sum (severity) of AWT-Pi10 and %LAA-950, respectively. CT1 and CT2, estimated in the learning set by cross-validated models of clinical and functional variables, were used to classify 373 patients in the testing set.A model based on diffusing capacity of the lung for carbon monoxide, total lung capacity and purulent sputum predicted CT1 (r50.64; p,0.01). A model based on forced expiratory volume in 1 s/vital capacity, functional residual capacity and purulent sputum predicted CT2 (r50.77; p,0.01). Classification of patients in the testing set obtained by model-predicted CT1 and CT2 reflected, according to correlations with clinical and functional variables, both COPD phenotype and severity.Multivariate models based on pulmonary function variables and sputum purulence classify patients according to overall severity and predominant phenotype of COPD as assessed quantitatively by CT. @ERSpublications Pulmonary function and sputum purulence models classify COPD patients by severity and phenotype as quantified by CT

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BODE-index, modified BODE-index and ADO-score in Chronic Obstructive Pulmonary Disease: Relationship with COPD phenotypes and CT lung density changes

Cited by 20 publications

References 32 publications

Adrenomedullin refines mortality prediction by the BODE index in COPD: the "BODE-A" index

Adrenomedullin refines mortality prediction by the BODE index in COPD: the "BODE-A" index

Present and future utility of computed tomography scanning in the assessment and management of COPD

Pulmonary function and sputum characteristics predict computed tomography phenotype and severity of COPD

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