Multidimensional indices in the assessment of chronic obstructive pulmonary disease

Respir Med. 2021 Aug-Sep:185:106519. doi: 10.1016/j.rmed.2021.106519. Epub 2021 Jun 22.

Abstract

Chronic obstructive pulmonary disease (COPD), a very common disease, is the third leading cause of death worldwide. Due to the significant heterogeneity of clinical phenotypes of COPD there is no single method suitable for predicting patients' health status and outcomes, and therefore multidimensional indices, assessing different components of the disease, were developed and are recommended for clinical practice by international guidelines. Several indices have been widely accepted: BODE and its modifications, ADO, DOSE, CODEX, COTE. They differ in their composition and aim, while they are more accurate and better validated in specific settings and populations. We review the characteristics, strengths and limitations of these indices, and we discuss their role in routine management of patients with COPD, as well as in specific clinical scenarios, such as resuscitation and ceiling of care, or decisions to offer more invasive treatments. This analysis may help clinicians to use those indexes in a more practical and appropriate way.

Keywords: ADO; BODE; CODEX; COPD; DOSE; Multidimensional indices.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Age Factors
  • Body Mass Index
  • Clinical Decision-Making
  • Disease Progression
  • Dyspnea
  • Exercise Tolerance
  • Female
  • Health Status
  • Humans
  • Male
  • Phenotype
  • Practice Guidelines as Topic
  • Prognosis
  • Pulmonary Disease, Chronic Obstructive / diagnosis*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / therapy
  • Resuscitation
  • Risk Assessment / methods*
  • Severity of Illness Index