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Published online before print June 25, 2008, 10.1183/09031936.00138507
Eur Respir J 2008; 32:1269-1274
Copyright ©ERS Journals Ltd 2008
doi: 10.1183/09031936.00138507

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The modified BODE index: validation with mortality in COPD

C. G. Cote1, V. M. Pinto-Plata2, J. M. Marin3, H. Nekach4, L. J. Dordelly4 and B. R. Celli2

1 Pulmonary and Critical Care, Bay Pines Veterans Administration Medical Center, 4 The Bay Pines Research Foundation, Bay Pines, FL, 2 Pulmonary and Critical Care, Caritas St. Elizabeth's Medical Center, Boston, MA, USA, 3 Hospital Miguel Servet, Zaragoza, Spain.

CORRESPONDENCE: C. G. Cote, Pulmonary and Critical Care Medicine, Bay Pines Veterans Administration Health Care System, 10, 000 Bay Pines Boulevard, Bay Pines, FL 33744, USA. Fax: 1 7273191090. E-mail: claudia.cote{at}med.va.gov

Keywords: Chronic obstructive pulmonary disease, exercise capacity, mortality

Received: October 21, 2007
Accepted June 16, 2008

Peak oxygen uptake (V'O2) remains the gold standard measurement of exercise capacity and has been associated with survival. A modified BODE (body mass index, airflow obstruction, dyspnoea, exercise capacity) index replacing the 6-min walk distance (6MWD) with V'O2 as % predicted (mBODE%) has been developed and found to have excellent correlation with the conventional BODE index.

The objectives of the present study were to compare the ability of the conventional BODE and the mBODE% to predict mortality in 444 patients with chronic obstructive pulmonary disease (COPD) followed for a mean±SD period of 71±34 months. Anthropometrics, spirometry, lung volumes, comorbidity, cardiopulmonary cyclo-ergometry test and 6MWD were determined at entry.

The mean BODE indices for the cohort were: BODE 4.1±2 and mBODE% 5.5±2. Both indices were significantly correlated with mortality. Logistic regression analysis with COPD survival as the dependent variable identified the BODE index, Charlson's and exercise capacity (in W) as variables associated with this outcome.

In conclusion, the conventional BODE index, which uses the 6-min walk distance, predicts mortality in chronic obstructive pulmonary disease as well as the modified index using peak oxygen uptake. The results support the use of the simpler index, which includes the 6-min walk distance in the comprehensive evaluation of patients with chronic obstructive pulmonary disease.




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