PT  - JOURNAL ARTICLE
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  - Pablo Martínez-Camblor
AU  - Marc Miravitlles
AU  - Bartolome R. Celli
AU  - Joan B. Soriano
TI  - Multicomponent indices to predict survival in COPD: the COCOMICS study
AID  - 10.1183/09031936.00121012
DP  - 2013 Aug 01
TA  - European Respiratory Journal
PG  - 323--332
VI  - 42
IP  - 2
4099  - http://erj.ersjournals.com/content/42/2/323.short
4100  - http://erj.ersjournals.com/content/42/2/323.full
SO  - Eur Respir J2013 Aug 01; 42
AB  - Guidelines recommend defining chronic obstructive pulmonary disease (COPD) by airflow obstruction and other factors, but no studies have evaluated the ability of existing multicomponent indices to predict mortality up to 10 years. We conducted a patient-based pooled analysis. Survival analysis and C statistics were used to determine the best COPD index/indices according to several construct variables and by varying time-points. Individual data of 3633 patients from 11 COPD cohorts were collected, totalling the experience of 15 878 person-years. Overall, there were 1245 death events within our cohorts, with a Kaplan–Meier survival of 0.963 at 6 months, which was reduced to 0.432 at 10 years. In all patients, ADO (age, dyspnoea and forced expiratory volume in 1 s), BODE (body mass index, airflow obstruction, dyspnoea and exercise capacity) and e-BODE (BODE plus exacerbations) were the best indices to predict 6-month mortality. The ADO index was the best to predict 12-month (C statistic 0.702), 5-year (C statistic 0.695) and 10-year mortality (C statistic 0.698), and was significantly better than BODE (all p<0.05). The best indices to predict death by C statistics when adjusting by age were e-BODE, BODEx (substitution of exacerbations for exercise capacity) and BODE. No index predicts short-term survival of COPD well. All BODE modifications scored better than ADO after age adjustment. The ADO and BODE indices are overall the most valid multicomponent indices to predict time to death in all COPD patients.