Efficiency of different multidimensional indexes for the assessment of the risk of exacerbations in patients with COPD

Abstract

Background: COPD is a mainly chronic respiratory disease, a great number of patients suffer from exacerbations, which are defined as an acute worsening of respiratory symptoms requiring a change in treatment. Exacerbations are an important medical and healthcare problem at the global level.

The aim of the study was to compare the efficiency of different multidimensional indexes for the assessment of the risk of exacerbations in patients with COPD.

Methods: The study was conducted in 433 patients with COPD. Spirometric data were analyzed (FEV1, FVC, FEV1/FVC). Were applied different multidimensional indexes: BODE, e-BODE, BODEx, ADO, DOSE and CODEX.

Results: The cohort consisted of 433 COPD patients of which 352 (81%) men and 81 (19%) women with mean age 62,7 ± 9,8 years. The multidimensional index E-BODE demonstrated excellent discriminatory power for the assessment of the risk of exacerbations (E-BODE AUC 0.935). CODEX, BODEx and DOSE showed good discriminatory power (CODEX AUC – 0.836, BODEx AUC - 0.829, DOSE AUC - 0.825). While BODE and ADO underestimated the risk of COPD exacerbations (BODE AUC - 0.662 and ADO AUC - 0.613).

Conclusions: Our analyses showed best discriminatory performance for the E-BODE index in patients with COPD for the assessment of the risk of exacerbations.