Prognostic assessment in COPD without lung function : the B-AE-D indices
Boeck, Lucas (University Hospital Basel (Basilea, Suïssa))
Soriano, Joan B.. (Instituto de Investigación Hospital Universitario de la Princesa)
Brusse-Keizer, Marjolein (Medical School Twente, Medisch Spectrum Twente, Enschede, The Netherlands)
Blasi, Francesco (Dept of Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Ospedale Maggiore Policlinico Cà Granda, Milan, Italy)
Kostikas, Konstantinos (University of Thessaly Medical School, Larissa, Greece)
Boersma, Wim (Dept of Pneumology, Medisch Centrum, Alkmaar, The Netherlands)
Milenkovic, Branislava (Clinic for Pulmonary Diseases, Clinical Centre of Serbia, Belgrade, Serbia)
Louis, Renaud (Dept of Pneumology, University of Liege, Liege, Belgium)
Lacoma, Alicia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Djamin, Remco (Dept of Pneumology, Amphia Hospital, Breda, The Netherlands)
Aerts, Joachim (Dept of Pneumology, Amphia Hospital, Breda, The Netherlands)
Torres, Antoni (Hospital Clínic i Provincial de Barcelona)
Rohde, Gernot (Dept of Respiratory Medicine, Maastricht University Medical Center, Maastricht, The Netherlands)
Welte, Tobias (Dept of Pneumology, Medizinische Hochschule, Hannover, Germany)
Martinez-Camblor, Pablo (Universidad Autónoma de Chile)
Rakic, Janko (University Hospital Basel (Basilea, Suïssa))
Scherr, Andreas (University Hospital Basel (Basilea, Suïssa))
Koller, Michael (University Hospital Basel (Basilea, Suïssa))
van der Palen, Job (Medical School Twente, Medisch Spectrum Twente, Enschede, The Netherlands)
Marin, Jose M. (Hospital Universitario Miguel Servet (Saragossa))
Alfageme, Inmaculada (Hospital Universitario Virgen de Valme (Sevilla, Andalusia))
Almagro, Pere (Mútua Terrassa)
Casanova, Ciro (Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife))
Esteban, Cristobal (Hospital de Galdakao (Usansolo, Biscaia))
Soler-Cataluña, Juan J. (Hospital Arnau de Vilanova (Lleida, Catalunya))
De Torres, Juan Pablo (Clínica Universidad de Navarra)
Miravitlles, Marc (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Celli, Bartolomé R. (Brigham and Women's Hospital (Boston, Estats Units d'Amèrica))
Tamm, Michael (University Hospital Basel (Basilea, Suïssa))
Stolz, Daiana (University Hospital Basel (Basilea, Suïssa))
Universitat Autònoma de Barcelona

Date:	2016
Abstract:	Several composite markers have been proposed for risk assessment in chronic obstructive pulmonary disease (COPD). However, choice of parameters and score complexity restrict clinical applicability. Our aim was to provide and validate a simplified COPD risk index independent of lung function. The PROMISE study (n=530) was used to develop a novel prognostic index. Index performance was assessed regarding 2-year COPD-related mortality and all-cause mortality. External validity was tested in stable and exacerbated COPD patients in the ProCOLD, COCOMICS and COMIC cohorts (total n=2988). Using a mixed clinical and statistical approach, body mass index (B), severe acute exacerbations of COPD frequency (AE), modified Medical Research Council dyspnoea severity (D) and copeptin (C) were identified as the most suitable simplified marker combination. 0, 1 or 2 points were assigned to each parameter and totalled to B-AE-D or B-AE-D-C. It was observed that B-AE-D and B-AE-D-C were at least as good as BODE (body mass index, airflow obstruction, dyspnoea, exercise capacity), ADO (age, dyspnoea, airflow obstruction) and DOSE (dyspnoea, obstruction, smoking, exacerbation) indices for predicting 2-year all-cause mortality (c-statistic: 0. 74, 0. 77, 0. 69, 0. 72 and 0. 63, respectively; Hosmer-Lemeshow test all p>0. 05). Both indices were COPD specific (c-statistic for predicting COPD-related 2-year mortality: 0. 87 and 0. 89, respectively). External validation of B-AE-D was performed in COCOMICS and COMIC (c-statistic for 1-year all-cause mortality: 0. 68 and 0. 74; c-statistic for 2-year all-cause mortality: 0. 65 and 0. 67; Hosmer-Lemeshow test all p>0. 05). The B-AE-D index, plus copeptin if available, allows a simple and accurate assessment of COPD-related risk. The B-AE-D indices allow a simple and accurate assessment of COPD-related risk in the absence of lung function.
Note:	Altres ajuts: A. Schötzau performed data management of PROMISE for which he received financial compensation.Thermo Scientific Biomarkers (Hennigsdorf, Germany) provided all the reagents for copeptin measurements.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	European respiratory journal, Vol. 47 (april 2016) , p. 1635-1644, ISSN 1399-3003

DOI: 10.1183/13993003.01485-2015
PMID: 27103389

10 p, 345.6 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles