The SAFE (SGRQ score, air-flow limitation and exercise tolerance) Index: a new composite score for the stratification of severity in chronic obstructive pulmonary disease

Abstract

Background: This study was proposed to develop a composite of outcome measures using forced expiratory volume percentage of predicted, exercise capacity and quality of life scores for assessment of chronic obstructive pulmonary disease (COPD) severity. Materials and methods: Eighty-six patients with COPD were enrolled into a prospective, observational study at the respiratory outpatient clinic, National University Hospital Malaysia (Hospital Universiti Kebangsaan Malaysia -HUKM), Kuala Lumpur. Results: Our study found modest correlation between the forced expiratory volume in 1 s (FEV 1 ), 6 min walk distance and the SGRQ scores with mean (SD) values of 0.97 (0.56) litres/s, 322 (87) m and 43.7 (23.6)%, respectively. K-Means cluster analysis identified four distinct clusters which reached statistical significance which was refined to develop a new cumulative staging system. The SAFE Index score correlated with the number of exacerbations in 2 years (r = 0.497, p,0.001). Conclusion: We have developed the SGRQ, Air-Flow limitation and Exercise tolerance Index (SAFE Index) for the stratification of severity in COPD. This index incorporates the SGRQ score, the FEV 1 % predicted and the 6 min walk distance. The SAFE Index is moderately correlated with the number of disease exacerbations.

Fatigue and multidimensional disease severity in chronic obstructive pulmonary disease

“…The SAFE index consists of the SGRQ score, FEV 1 , and 6 MWT distance [8]. The maximum possible score is 9.…”

Multicomponent indices to predict survival in COPD: the COCOMICS study

“…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].…”

Classification of frailty using the Kihon checklist: A cluster analysis of older adults in urban areas

“…A previous study used cluster analysis to determine the degree of obstructive pulmonary disease according to health-related quality of life scores and physical function. 28 Similarly, we characterized frailty in terms of clusters using the Kihon checklist, because the operational definition of frailty is based on the decline of physical and psychological function. The differences in the pattern of decline were reasonable among the cluster groups.…”