OBJECTIVES: The BODE (BMI, Obstruction - FEV1, Dyspnoea - mMRC, Exercise - 6-MWT) and the ADO (Age, Dyspnoea - mMRC, Obstruction - FEV1) indices are widely used prognosis assessment tools for long-term mortality prediction in COPD patients but subject to limitations for use in daily clinical practice. The aim of this research was to construct a prognostic instrument that prevents these limitations and which would serve as a complementary prognostic tool for clinical use in these patients. METHODS AND PARTICIPANTS: The data of 699 COPD subjects were extracted from the Czech Multicentre Research Database (CMRD) of COPD patients (the derivation cohort) and analysed to identify factors associated with the long-term risk of mortality. These were entered into the ROC analysis and reclassification analysis. Those with the strongest discriminative power were used to construct the new index (CADOT). The new index was validated on 187 patients of the CIROCO+ cohort (Netherlands; the validation cohort). RESULTS: The CADOT was constructed by adding two newly identified prognosis-determining factors, chronic heart failure (CHF) and TLCO, to the ADO index. In a head-to-head comparison, the CADOT index showed highest c-statistic values compared to the BODE and ADO indices (0.701 vs 0.677 vs 0.644, respectively). The prognostic power was more definitive when applied to the Dutch validation (CIROCO+) cohort (0.842 vs 0.799 vs 0.825, respectively). CONCLUSIONS: The CADOT index has comparable prognostic power to the BODE and ADO indices. The CADOT is complementary/an alternative to the BODE (if 6-MWT is not feasible) and ADO (with less dependence on the age factor) indices. TRIAL REGISTRATION: ClinicalTrials.gov (NCT01923051).

Boehringer Ingelheim s r o Prague Czech Republic

COPD Center Sahlgrenska University Hospital Institute of Medicine University of Gothenburg Sweden

Department of Research and Education CIRO Center of Expertise for Chronic Organ Failure Horn The Netherlands

Department of Respiratory Diseases University Hospital Brno Brno Czech Republic

Department of Respiratory Medicine Maastricht University Medical Centre NUTRIM School of Nutrition and Translational Research in Metabolism Maastricht The Netherlands

Department of Respiratory Medicine University Hospital Olomouc Czech Republic

Faculty of Medicine Masaryk University Brno Czech Republic

Institute of Biostatistics and Analyses Ltd Brno Czech Republic

Pulmonary Department Bulovka Hospital Prague Czech Republic

Pulmonary Department University Hospital Hradec Kralove and Faculty of Medicine Hradec Kralove Charles University Czech Republic

Pulmonary Department University Hospital Ostrava Czech Republic

REVAL Rehabilitation Research Center BIOMED Biomedical Research Institute Faculty of Rehabilitation Sciences Hasselt University Diepenbeek Belgium

References provided by Crossref.org

Prognostic Properties of the GOLD 2023 Classification System

The Relation Between Clinical Phenotypes, GOLD Groups/Stages and Mortality in COPD Patients - A Prospective Multicenter Study

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ClinicalTrials.gov
NCT01923051