The Modified BODE Index: Validation with Mortality in COPD

¹ Pulmonary and Critical Care, Bay Pines VA Medical Center, Bay Pines, Florida
² Pulmonary, and Critical, Caritas-St. Elizabeth's Medical Center, Boston, Massachusetts
³ Hospital Miguel Servet, Zaragoza, Spain
⁴ The Bay Pines Research Foundation

^* To whom correspondence should be addressed. E-mail: claudia.cote{at}med.va.gov.

	Abstract

The peak oxygen uptake (VO₂) remains the gold standard measurement of exercise capacity and has been associated with survival. A modified BODE index replacing the 6MWD with peak VO₂ as % of predicted (mBODE %) has been developed and found to have excellent correlation with the conventional BODE index. Objectives: To compare the ability of the conventional BODE and the mBODE% to predict mortality in 444 patients with COPD followed over 71±34 months. Anthropometrics, spirometry, lung volumes, co-morbidity, cardiopulmonary cyclo-ergometry test, and 6MWD were determined at entry. Results: The mean BODE indexes for the cohort were: BODE=4.1±2 and mBODE %=5.5±2, p<0.0001. Both indexes correlated with mortality; BODE (r=0.32, p<0.0001) and mBODE % (r=0.31, p<0.0001). Logistic regression analysis with COPD survival as the dependent variable identified the BODE index, Charlson's and watts as variables associated with this outcome (% deviance=17.1, p=0.00001). Conclusion: the conventional BODE index which uses 6MWD predicts mortality in COPD as well as the modified index using peak VO2%. These results support the use of the simpler index which includes the 6MWD in the comprehensive evaluation of patients with COPD.

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