Body mass index, airflow obstruction and dyspnea and body mass index, airflow obstruction, dyspnea scores, age and pack years-predictive properties of new multidimensional prognostic indices of chronic obstructive pulmonary disease in primary care

Ansari, Khalid; Keaney, N. P.; Kay, A.B.; Price, Monica; Munby, Joan; Billett, Andrew; Haggerty, Sharon; Taylor, Ian; Al-Otaibi, Hajed M.

doi:10.4103/1817-1737.191866

Cited by 9 publications

(7 citation statements)

References 36 publications

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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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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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“…24 Low muscle mass and increased adiposity were generally associated with increased airway obstruction, lower 6MWD, increased dyspnea severity, and low or increased BMI, respectively. The BODE index is multifactorial and observed to be associated with biomarkers of inflammation (TNF-alpha and leptin levels), 49 physical inactivity, 50 malnutrition, hypoxemia, and smoking, 51 known risk factors for disease progression. Furthermore, BODE index has been shown to be responsive to pulmonary rehabilitation with greater than 70% of 83 COPD participants demonstrating > 1 point BODE index change, specifically in the indices of lung function, dyspnea, and exercise capacity, but no change in BMI.…”

Section: Discussionmentioning

confidence: 99%

Computed tomography-based body composition measures in COPD and their association with clinical outcomes: A systematic review

Nicholson¹,

Orsso

Nourouzpour

et al. 2022

Chron Respir Dis

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Background Computed tomography (CT) is commonly utilized in chronic obstructive pulmonary disease (COPD) for lung cancer screening and emphysema characterization. Computed tomography-morphometric analysis of body composition (muscle mass and adiposity) has gained increased recognition as a marker of disease severity and prognosis. This systematic review aimed to describe the CT-methodology used to assess body composition and identify the association of body composition measures and disease severity, health-related quality of life (HRQL), cardiometabolic risk factors, respiratory exacerbations, and survival in patients with COPD. Methods Six databases were searched (inception-September 2021) for studies evaluating adult COPD patients using thoracic or abdominal CT-muscle or adiposity body composition measures. The systematic review was conducted in accordance with the PRISMA guidelines. Results Twenty eight articles were included with 15,431 COPD patients, across all GOLD stages with 77% males, age range (mean/median 59–78 years), and BMI range 19.8–29.3 kg/m2. There was heterogeneity in assessment of muscle mass and adiposity using thoracic ( n = 22) and abdominal ( n = 8) CT-scans, capturing different muscle groups, anatomic locations, and adiposity compartments (visceral, subcutaneous, and epicardial). Low muscle mass and increased adiposity were associated with increased COPD severity measures (lung function, exercise capacity, dyspnea) and lower HRQL, but were not consistent across studies. Increased visceral adiposity ( n = 6) was associated with cardiovascular disease or risk factors (hypertension, hyperlipidemia, and diabetes). Low muscle CSA was prognostic of respiratory exacerbations or mortality in three of six studies, whereas the relationship with increased intermuscular adiposity and greater mortality was only observed in one of three studies. Conclusion There was significant variability in CT-body composition measures. In several studies, low muscle mass was associated with increased disease severity and lower HRQL, whereas adiposity with cardiovascular disease/risk factors. Given the heterogeneity in body composition measures and clinical outcomes, the prognostic utility of CT-body composition in COPD requires further study.

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“…Mean BODE index in our study was 4.03. Fanny et al (7) conducted a prospective cohort study involving 243(208males) COPD patients hospitalized for acute exacerbations of COPD [AECOPD], in this study distribution of BODE index is as shown in figure 5. In our study group, 66.7% patients belonged to quartile 2 and 3, in comparison to above study population, in which 61% patients belonged to quartile 2 and 3.…”

Section: Discussionmentioning

confidence: 99%

BODE Index: A Predictor of COPD Exacerbation

Modi¹

2018

jmscr

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Introduction: The severity of COPD (chronic obstructive pulmonary disease) is often graded using parameter like Forced Expiratory Volume (FEV1). The BODE (body mass index, degree of airflow obstruction, dyspnea grading and exercise testing) index is a multi-dimensional tool taking into account body mass index, severity of obstruction, dyspnea grading and 6MWT (six minute walk test) to assess severity of COPD. Objective: To study BODE index as a predictor of risk of exacerbation for improving COPD outcome. Materials and Methods: We conducted a prospective study over a period of 2 years, on 60 stable COPD patients by evaluating the body-mass index, spirometry, Modified Medical Research Council (mMRC) dyspnea scale and 6MWT and categorizing into mild, moderate and severe COPD cases on the basis of spirometry and into 4 quartiles on the basis of BODE index value (scores 0-2, 3-4, 5-6 and 7-10). We investigated the prognostic value of BODE quartiles for both the number and severity of exacerbations requiring ambulatory treatment, emergency room visit or hospitalization. Results: In our study, spirometry showed mild obstruction in 16.7%, moderate obstruction in 26.7%, severe obstruction in 38.3% and very severe obstruction in 18.3% of patients. According to BODE score 52% of patients were quartile 1, 21% quartile 2, 15% quartile 3 and 12% were quartile 4. There was a significant relation between BODE index and COPD severity (p < 0.001). In our study, 8.3% patients had no exacerbation; maximum number of exacerbation were 7 observed in 8.3 % patients and 21.7% of patients had 3 exacerbations in 2 years and 16.7% patients had 1 exacerbation in 2 years. It was observed that higher the BODE index; greater is the severity of COPD and more are the number of exacerbations. Conclusion: BODE index should be calculated in every COPD patients for better prediction of risk of exacerbation, hospitalization and for judicious referral of patients with COPD, thereby preventing the wastage of the limited resources available.

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Body mass index, airflow obstruction and dyspnea and body mass index, airflow obstruction, dyspnea scores, age and pack years-predictive properties of new multidimensional prognostic indices of chronic obstructive pulmonary disease in primary care

Cited by 9 publications

References 36 publications

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

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

Computed tomography-based body composition measures in COPD and their association with clinical outcomes: A systematic review

BODE Index: A Predictor of COPD Exacerbation

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