BODE index or geriatric multidimensional assessment for the prediction of very-long-term mortality in elderly patients with chronic obstructive pulmonary disease? A prospective cohort study

Pedone, Claudio; Scarlata, Simone; Forastiére, Francesco; Bellia, Vincenzo; Incalzi, Raffaele Antonelli

doi:10.1093/ageing/aft197

Cited by 17 publications

(9 citation statements)

References 23 publications

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“…Pendone C et al, 7 found in their study that the mean age of the patients was 73.3 years and the male to female ratio was 3.29:1 which is in accordance to the findings of the present study. 7 Ko FW et al, found a higher male to female ratio in their study and they reported that it was 5.94:1 which is higher than the findings of the present study. 8 "The lung health study" was carried out in people who smoked and were aged 35-60 years of age and it was found that they had obstruction in the airway which was of mild to moderate in nature.…”

Section: Discussioncontrasting

confidence: 70%

A study of clinical profile of patients with chronic pulmonary obstructive disease at a tertiary care centre in North Karnataka, India

2019

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Background: Chronic pulmonary obstructive disease (COPD) has been responsible for the decreased quality of life as well as increased morbidity and mortality. Globally it has been estimated that nearly three million die yearly due to COPD and more likely to occupy the third place of mortality by 2030. The objective of the present endeavour was to study clinical profile of patients with chronic pulmonary obstructive disease at a tertiary care centre.Methods: A hospital based cross sectional study was carried out among 200 cases of COPD. Their detailed history, thorough clinical examination and parameters like hemoglobin, serum creatinine, protein etc were investigated. The presence of co-morbidities was noted.Results: As the age increased the prevalence of the COPD increased and highest was found out to be in the age group of above 60 years of age. Males were more affected with COPD as compared with females. The male to female ratio was found out to be 2.4:1. The smokers were more compared to the non smokers. The prevalence of smoking among COPD was noted to be 66% compared to 34% as non smokers. Least proportion of patients of the COPD had fever i.e. in 22% of the cases. Cough was found in 83% of the cases. Breathlessness was found out to be in 98% of the cases. 15% of the cases of the COPD had diabetes only as the co-morbidity along with COPD and no other co-morbidity.Conclusions: Breathlessness was the most common symptom at presentation and diabetes and hypertension were the most common co-morbidities found.

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Section: Discussioncontrasting

confidence: 70%

A study of clinical profile of patients with chronic pulmonary obstructive disease at a tertiary care centre in North Karnataka, India

2019

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“…Supplementary table F shows all the external validation studies of the prognostic models for outcome prediction in COPD patients 2325 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81…”

Section: Resultsmentioning

confidence: 99%

Prognostic models for outcome prediction in patients with chronic obstructive pulmonary disease: systematic review and critical appraisal

Bellou

Belbasis

Konstantinidis

et al. 2019

BMJ

127

121

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Objective To map and assess prognostic models for outcome prediction in patients with chronic obstructive pulmonary disease (COPD). Design Systematic review. Data sources PubMed until November 2018 and hand searched references from eligible articles. Eligibility criteria for study selection Studies developing, validating, or updating a prediction model in COPD patients and focusing on any potential clinical outcome. Results The systematic search yielded 228 eligible articles, describing the development of 408 prognostic models, the external validation of 38 models, and the validation of 20 prognostic models derived for diseases other than COPD. The 408 prognostic models were developed in three clinical settings: outpatients (n=239; 59%), patients admitted to hospital (n=155; 38%), and patients attending the emergency department (n=14; 3%). Among the 408 prognostic models, the most prevalent endpoints were mortality (n=209; 51%), risk for acute exacerbation of COPD (n=42; 10%), and risk for readmission after the index hospital admission (n=36; 9%). Overall, the most commonly used predictors were age (n=166; 41%), forced expiratory volume in one second (n=85; 21%), sex (n=74; 18%), body mass index (n=66; 16%), and smoking (n=65; 16%). Of the 408 prognostic models, 100 (25%) were internally validated and 91 (23%) examined the calibration of the developed model. For 286 (70%) models a model presentation was not available, and only 56 (14%) models were presented through the full equation. Model discrimination using the C statistic was available for 311 (76%) models. 38 models were externally validated, but in only 12 of these was the validation performed by a fully independent team. Only seven prognostic models with an overall low risk of bias according to PROBAST were identified. These models were ADO, B-AE-D, B-AE-D-C, extended ADO, updated ADO, updated BODE, and a model developed by Bertens et al. A meta-analysis of C statistics was performed for 12 prognostic models, and the summary estimates ranged from 0.611 to 0.769. Conclusions This study constitutes a detailed mapping and assessment of the prognostic models for outcome prediction in COPD patients. The findings indicate several methodological pitfalls in their development and a low rate of external validation. Future research should focus on the improvement of existing models through update and external validation, as well as the assessment of the safety, clinical effectiveness, and cost effectiveness of the application of these prognostic models in clinical practice through impact studies. Systematic review registration PROSPERO CRD42017069247

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“…In the last decade, multidimensional scores have been introduced in order to better assess COPD outcomes, particularly the mortality risk, even if results were variable due to their different specificity and sensitivity [3,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23]. The vast majority of studies have stated that exacerbations represent the main driver of COPD burden because they can affect morbidity, quality of life, hospitalizations, mortality, and related healthcare expenditure [24,25,26,27,28].…”

Section: Cost Trends In Real Lifementioning

confidence: 99%

COPD: The Annual Cost-Of-Illness during the Last Two Decades in Italy, and Its Mortality Predictivity Power

Negro

2019

Healthcare

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Chronic obstructive pulmonary disease (COPD) is a progressive pathological condition characterized by a huge epidemiological and socioeconomic impact worldwide. In Italy, the actual annual cost of COPD was assessed for the first time in 2002: the mean cost per patient per year was €1801 and ranged from €1500 to €3912, depending on COPD severity. In 2008, the mean annual cost per patient was €2723.7, ranging from €1830.6 in mild COPD up to €5451.7 in severe COPD. In 2015, it was €3291, which is 20.8% and 82.7% higher compared to the costs estimated in 2008 and 2002, respectively. In all these studies, the major cost component was direct costs, in particular hospitalization costs due to exacerbations, which corresponded to 59.9% of the total cost and 67.2% of direct costs, respectively. When the annual healthcare expenditure per patient is related to the length of survival by means of the PRO-BODE Index (PBI, which is the implementation of the well-known BODE Index with costs due to annual exacerbations and/or hospitalizations), the annual cost of care proved much more strictly and inversely proportional to patients’ survival at three years, with the highest regression coefficient (r = −0.58) of all the multidimensional indices presently available, including the BODE Index (r = −021). In Italy, even though tobacco smoking has progressively declined by up to 21% in the general population, the economic impact of COPD has shown relentless progression over the last two decades, confirming that the present national health system organization is still insufficient for facing the issue of chronic diseases, in particular COPD, effectively. The periodic assessment of costs is an effective instrument for care providers in predicting COPD mortality, and for decision makers for updating and planning their social, economic, and political strategies.

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BODE index or geriatric multidimensional assessment for the prediction of very-long-term mortality in elderly patients with chronic obstructive pulmonary disease? A prospective cohort study

Abstract: : Both the 'classic' MDA and the BODE index are comparably associated with mortality, even at very long term, in elderly people with COPD.

Cited by 17 publications

References 23 publications

A study of clinical profile of patients with chronic pulmonary obstructive disease at a tertiary care centre in North Karnataka, India

A study of clinical profile of patients with chronic pulmonary obstructive disease at a tertiary care centre in North Karnataka, India

Prognostic models for outcome prediction in patients with chronic obstructive pulmonary disease: systematic review and critical appraisal

COPD: The Annual Cost-Of-Illness during the Last Two Decades in Italy, and Its Mortality Predictivity Power

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