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Development of a decision tree to assess the severity and prognosis of stable COPD

C. Esteban, I. Arostegui, J. Moraza, M. Aburto, J.M. Quintana, J. Pérez-Izquierdo, S. Aizpiri, A. Capelastegui
European Respiratory Journal 2011; DOI: 10.1183/09031936.00189010
C. Esteban
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  • For correspondence: cristobal_esteban@yahoo.es
I. Arostegui
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J. Moraza
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M. Aburto
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J.M. Quintana
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J. Pérez-Izquierdo
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S. Aizpiri
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A. Capelastegui
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Abstract

The aim of this study was to develop and validate a new method: a classification and regression tree (CART) based on easily accessible measures to predict mortality in patients with stable COPD.

Prospective study of two independent prospective cohorts: a derivation cohort with 611 recruited patients and a validation cohort with 348 patients, all followed for 5 years. CART analysis was used to predict 5-year mortality risk using the following covariates from the derivation cohort: age, forced expiratory volume in the first second as a percentage of predicted (FEV1%), dyspnoea, physical activity, general health, and number of hospital admissions for COPD exacerbations in the prior 2 years.

Age (≥75 years or <75) provided the first branch of the COPD-CART. The highest mortality risk (0.74) was seen in patients older than 75 with higher levels of dyspnoea and with FEV1% <50%. Patients with the lowest risk of 5-year mortality (0.04) were those under age 55 years with FEV1% >35% and with 1 or no recent hospitalizations for COPD exacerbations.

A simple decision tree that uses variables generally gathered by physicians can provide a quick assessment of the severity of the disease, as measured by the risk of 5-year mortality.

  • COPD
  • Decision trees
  • Severity score
  • ERS
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Development of a decision tree to assess the severity and prognosis of stable COPD
C. Esteban, I. Arostegui, J. Moraza, M. Aburto, J.M. Quintana, J. Pérez-Izquierdo, S. Aizpiri, A. Capelastegui
European Respiratory Journal May 2011, erj01890-2010; DOI: 10.1183/09031936.00189010

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Development of a decision tree to assess the severity and prognosis of stable COPD
C. Esteban, I. Arostegui, J. Moraza, M. Aburto, J.M. Quintana, J. Pérez-Izquierdo, S. Aizpiri, A. Capelastegui
European Respiratory Journal May 2011, erj01890-2010; DOI: 10.1183/09031936.00189010
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