COPD severity score as a predictor of failure in exacerbations of COPD. The ESFERA study

Miravitlles, Marc; Izquierdo, Iñaki; Herrejón, Alberto; Torres, Juan Vicente; Baró, Eva; Borja, Javier

doi:10.1016/j.rmed.2010.12.020

Cited by 36 publications

(41 citation statements)

References 36 publications

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“…The COPDSS was adopted into routine clinical practice after previous validation studies [26,27]. Unlike the BODE index [31], the other indices do not require the performance of exercise testing and could be calculated from the data recorded during the routine health care process.…”

Section: Discussionmentioning

confidence: 99%

“…It has recently been demonstrated that these indices may be useful in the assessment of COPD severity as well as in the prediction of different negative events in ambulatory COPD patients (e.g. mortality, health care utilisation, future hospitalisations, failures in COPD exacerbations) [24,25,26,27,28,29,30], but to our knowledge, no studies have investigated their usefulness in hospitalised patients. We found that the COPDSS, BODEx and DOSE but not the ADO index were associated with adverse outcome on univariate analysis, but only the BODEx and DOSE indices appeared as independent adverse prognostic factors in the multivariate models B and C, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…The COPD severity score (COPDSS) [24] consists of a series of questions about respiratory symptoms, COPD treatment and previous exacerbations (maximum score 35). It was proven useful in ambulatory patients for the assessment of COPD severity and prediction of health care utilisation and outcomes of exacerbations [24,25,26] and was therefore adopted into routine clinical practice in our institution. The COPDSS questionnaire was previously translated and validated in Spanish [27].…”

Section: Methodsmentioning

confidence: 99%

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Predictors of Adverse Outcome in Patients Hospitalised for Exacerbation of Chronic Obstructive Pulmonary Disease

Matković

Huerta²,

Soler³

et al. 2012

Respiration

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Background: It is crucial to identify risk factors for poor evolution of patients admitted to hospital with chronic obstructive pulmonary disease (COPD) in order to provide adequate intensive therapy and closer follow-up. Objectives: To identify predictors of adverse outcomes in patients hospitalised for exacerbation of COPD. Methods: A prospective, observational study was conducted in patients admitted for exacerbation of COPD. Demographic and clinical parameters were evaluated, including different multidimensional prognostic scores. Adverse outcomes included the following: death during hospitalisation or 1-month follow-up, intensive care unit admission, invasive or non-invasive mechanical ventilation, prolonged hospitalisation (>11 days) and COPD-related emergency visit or readmission within 1 month after discharge. Univariate and multivariate analysis were performed. Results: Of 155 patients included, an adverse outcome occurred in 69 (45%). Patients with an adverse outcome had lower forced expiratory volume in 1 s (p = 0.004) and more frequent exacerbations (p = 0.011), more frequently used oxygen at home (p = 0.042) and presented with lower pH (p < 0.001), lower ratio of arterial oxygen pressure to the fraction of inspired oxygen (p = 0.006), higher arterial carbon dioxide pressure (p < 0.001) and a worse score on several prognostic indices at admission. Independent predictors of adverse outcome were exacerbation of COPD in the previous year [odds ratio 3.9, 95% confidence interval (CI) 1.6–9.9; p = 0.004], hypercapnia (odds ratio 9.4, 95% CI 3.7–23.6; p < 0.001) and hypoxaemia (odds ratio 4.3, 95% CI 1.5–12.6; p = 0.008). In the presence of all three characteristics, the probability of an adverse outcome was 95%, while hypercapnia was the strongest prognostic factor with a risk of 54%. Conclusions: Patients with previous exacerbation of COPD, hypercapnia and hypoxaemia had the highest risk of an unfavourable evolution. The calculation of prognostic indices did not provide additional discriminative power.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Predictors of Adverse Outcome in Patients Hospitalised for Exacerbation of Chronic Obstructive Pulmonary Disease

Matković

Huerta²,

Soler³

et al. 2012

Respiration

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“…We also calculated modifications of the BODE index, including the mBODE (which replaces 6MWD with oxygen uptake) [20], e-BODE (BODE plus exacerbations) [21], and BODEx (substitution of exacerbations for exercise capacity) [21]. We also calculated the ADO index (age, dyspnoea and FEV1) [22], the COPD Prognostic Index (CPI) (quality of life standardised by the Chronic Respiratory Questionnaire (CRQ) or St George's Respiratory Questionnaire (SGRQ), FEV1, age, sex, BMI, exacerbation history and cardiovascular disease history) [23], the SAFE index (quality of life by SGRQ, FEV1 and 6MWD) [24], the HADO index (health status, activity, dyspnoea and FEV1) [25], the COPDSS-COPD severity score (respiratory symptoms, systemic corticosteroid use, other COPD medication use, previous hospitalisation or intubation for respiratory disease and home oxygen use) [26,27], TARDIS (age, BMI, dyspnoea, airflow obstruction, hospitalisations and influenza vaccination) [28], and the DOSE index (dyspnoea, smoking status, FEV1 and prior exacerbation history) [29]. Comorbidities were quantified by means of the Charlson index, excluding COPD [30].…”

Section: Indices Calculationsmentioning

confidence: 99%

Multicomponent indices to predict survival in COPD: the COCOMICS study

Marı́n

Alfageme²,

Almagro

et al. 2012

Eur Respir J

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Guidelines recommend defining chronic obstructive pulmonary disease (COPD) by airflow obstruction and other factors, but no studies have evaluated the ability of existing multicomponent indices to predict mortality up to 10 years.We conducted a patient-based pooled analysis. Survival analysis and C statistics were used to determine the best COPD index/indices according to several construct variables and by varying time-points. Individual data of 3633 patients from 11 COPD cohorts were collected, totalling the experience of 15 878 person-years.Overall, there were 1245 death events within our cohorts, with a Kaplan-Meier survival of 0.963 at 6 months, which was reduced to 0.432 at 10 years. In all patients, ADO (age, dyspnoea and forced expiratory volume in 1 s), BODE (body mass index, airflow obstruction, dyspnoea and exercise capacity) and e-BODE (BODE plus exacerbations) were the best indices to predict 6-month mortality. The ADO index was the best to predict 12-month (C statistic 0.702), 5-year (C statistic 0.695) and 10-year mortality (C statistic 0.698), and was significantly better than BODE (all p,0.05). The best indices to predict death by C statistics when adjusting by age were e-BODE, BODEx (substitution of exacerbations for exercise capacity) and BODE.No index predicts short-term survival of COPD well. All BODE modifications scored better than ADO after age adjustment. The ADO and BODE indices are overall the most valid multicomponent indices to predict time to death in all COPD patients. @ERSpublicationsNo index predicts short-term survival of COPD well: all BODE modifications score better than ADO after age adjustment

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“…Near to these results, Miravitlles et al, 2011 (11) found more frequent exacerbation in patients in need for invasive MV (2.6±1.7) than those not requiring it (2.5±2) but to an insignificant degree. This may be explained that they studied frequency of exacerbations in the last year only.…”

Section: Jmscr Vol||06||issue||06||page 1024-1032||june 2018mentioning

confidence: 90%

Predictors of Need for Non-Invasive Mechanical Ventilation in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Abdelghany¹

2018

jmscr

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COPD severity score as a predictor of failure in exacerbations of COPD. The ESFERA study

Cited by 36 publications

References 36 publications

Predictors of Adverse Outcome in Patients Hospitalised for Exacerbation of Chronic Obstructive Pulmonary Disease

Predictors of Adverse Outcome in Patients Hospitalised for Exacerbation of Chronic Obstructive Pulmonary Disease

Multicomponent indices to predict survival in COPD: the COCOMICS study

Predictors of Need for Non-Invasive Mechanical Ventilation in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

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