PT - JOURNAL ARTICLE AU - Lucas Boeck AU - Joan B. Soriano AU - Marjolein Brusse-Keizer AU - Francesco Blasi AU - Konstantinos Kostikas AU - Wim Boersma AU - Branislava Milenkovic AU - Renaud Louis AU - Alicia Lacoma AU - Remco Djamin AU - Joachim Aerts AU - Antoni Torres AU - Gernot Rohde AU - Tobias Welte AU - Pablo Martinez-Camblor AU - Janko Rakic AU - Andreas Scherr AU - Michael Koller AU - Job van der Palen AU - Jose M. Marin AU - Inmaculada Alfageme AU - Pere Almagro AU - Ciro Casanova AU - Cristobal Esteban AU - Juan J. Soler-Cataluña AU - Juan P. de-Torres AU - Marc Miravitlles AU - Bartolome R. Celli AU - Michael Tamm AU - Daiana Stolz TI - Prognostic assessment in COPD without lung function: the B-AE-D indices AID - 10.1183/13993003.01485-2015 DP - 2016 Jun 01 TA - European Respiratory Journal PG - 1635--1644 VI - 47 IP - 6 4099 - http://erj.ersjournals.com/content/47/6/1635.short 4100 - http://erj.ersjournals.com/content/47/6/1635.full SO - Eur Respir J2016 Jun 01; 47 AB - 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 http://ow.ly/XFBox