RT Journal Article SR Electronic T1 Adrenomedullin refines mortality prediction by the BODE index in COPD: the “BODE-A” index JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 397 OP 408 DO 10.1183/09031936.00058713 VO 43 IS 2 A1 Daiana Stolz A1 Kostantinos Kostikas A1 Francesco Blasi A1 Wim Boersma A1 Branislava Milenkovic A1 Alicia Lacoma A1 Renaud Louis A1 Joachim G. Aerts A1 Tobias Welte A1 Antoni Torres A1 Gernot G.U. Rohde A1 Lucas Boeck A1 Janko Rakic A1 Andreas Scherr A1 Sabine Hertel A1 Sven Giersdorf A1 Michael Tamm YR 2014 UL http://erj.ersjournals.com/content/43/2/397.abstract AB The BODE (body mass index, airflow obstruction, dyspnoea, exercise capacity) index is well-validated for mortality prediction in chronic obstructive pulmonary disease (COPD). Concentrations of plasma pro-adrenomedullin, a surrogate for mature adrenomedullin, independently predicted 2-year mortality among inpatients with COPD exacerbation. We compared accuracy of initial pro-adrenomedullin level, BODE and BODE components, alone or combined, in predicting 1-year or 2-year all-cause mortality in a multicentre, multinational observational cohort with stable, moderate to very severe COPD. Pro-adrenomedullin was significantly associated (p<0.001) with 1-year mortality (4.7%) and 2-year mortality (7.8%) and comparably predictive to BODE regarding both (C statistics 0.691 versus 0.745 and 0.635 versus 0.679, respectively). Relative to using BODE alone, adding pro-adrenomedullin significantly improved 1-year and 2-year mortality prognostication (C statistics 0.750 and 0.818, respectively; both p<0.001). Pro-adrenomedullin plus BOD was more predictive than the original BODE including 6-min walk distance. In multivariable analysis, pro-adrenomedullin (likelihood ratio Chi-squared 13.0, p<0.001), body mass index (8.5, p=0.004) and 6-min walk distance (7.5, p=0.006) independently foretold 2-year survival, but modified Medical Research Council dyspnoea score (2.2, p=0.14) and forced expiratory volume in 1 s % predicted (0.3, p=0.60) did not. Pro-adrenomedullin plus BODE better predicts mortality in COPD patients than does BODE alone; pro-adrenomedullin may substitute for 6-min walk distance in BODE when 6-min walk testing is unavailable. Pro-adrenomedullin improves BODE prediction of mortality in COPD patients and may substitute for 6-min walk distance http://ow.ly/qV5M3