Discriminative and predictive properties of multidimensional prognostic indices of chronic obstructive pulmonary disease: a validation study in Taiwanese patients

Respirology. 2014 Jul;19(5):694-9. doi: 10.1111/resp.12313. Epub 2014 May 6.

Abstract

Background and objective: Chronic obstructive pulmonary disease (COPD) is a pulmonary disease with systemic involvement. Several multidimensional indices have been developed to predict long-term outcomes. However, these indices have not been compared and validated in Taiwanese patients with COPD.

Methods: A prospective, observational, hospital-based study was designed, and a total of 621 patients were recruited from May 2006 to December 2011. Patients followed at least 1 year were enrolled and 594 patients eligible for inclusion. Three prognostic indices--the ADO (age, dyspnoea and airflow obstruction), BODEx (body mass index, airflow obstruction, dyspnoea and exacerbations), and CPI (the COPD Prognostic Index)--were validated and the predictive power of each was analysed.

Results: The median follow-up of the 594 patients was 33 months (range 1-72 months), and the mortality rate was 19.2% (114 deaths). All indices were significantly predictive for all-cause mortality in our validation cohort. Furthermore, the C statistics of the three indices, indicating their predictive accuracy, were all >0.7 (area under the curve of the CPI 0.718, P < 0.001, ADO 0.702, P < 0.001, BODEx 0.702, P < 0.001).

Conclusions: ADO, BODEx and CPI scores are useful predictors of all-cause mortality with significantly discriminative properties in Taiwanese patients with COPD.

Keywords: age; airflow obstruction; body mass index; chronic obstructive pulmonary disease; dyspnoea and airflow obstruction; dyspnoea and exacerbations; mortality; prognostic index.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive / diagnosis*
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Disease, Chronic Obstructive / mortality*
  • Pulmonary Ventilation / physiology
  • Research Design*
  • Retrospective Studies
  • Severity of Illness Index
  • Taiwan / epidemiology