[en] 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.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Boeck, Lucas
Soriano, Joan B.
Brusse-Keizer, Marjolein
Blasi, Francesco
Kostikas, Konstantinos
Boersma, Wim
Milenkovic, Branislava
LOUIS, Renaud ; Centre Hospitalier Universitaire de Liège - CHU > Service de pneumologie - allergologie
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Bibliography
Rosenbaum L, Lamas D. Facing a "slow-motion disaster" - the UN Meeting on noncommunicable diseases. N Engl J Med 2011; 365: 2345-2348.
Mannino DM, Buist AS. Global burden of COPD: risk factors, prevalence, and future trends. Lancet 2007; 370: 765-773.
Celli BR, Cote CG, Marín JM, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 2004; 350: 1005-1012.
Puhan MA, Garcia-Aymerich J, Frey M, et al. Expansion of the prognostic assessment of patients with chronic obstructive pulmonary disease: the updated BODE index and the ADO index. Lancet 2009; 374: 704-711.
Jones RC, Donaldson GC, Chavannes NH, et al. Derivation and validation of a composite index of severity in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2009; 180: 1189-1195.
Celli BR, Marin JM, Cote CG, et al. Prognostic assessment of patients with COPD. Lancet 2009; 374: 1885-1887.
Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax 2003; 58: 377-382.
Stolz D, Kostikas K, Blasi F, et al. Adrenomedullin refines mortality prediction by the BODE index in COPD: the "BODE-A" index. Eur Respir J 2014; 43: 397-408.
Stolz D, Meyer A, Rakic J, et al. Mortality risk prediction in COPD by a prognostic biomarker panel. Eur Respir J 2014; 44: 1557-1570.
Stolz D, Christ-Crain M, Bingisser R, et al. Antibiotic treatment of exacerbations of COPD. Chest 2007; 131: 9-19.
Marín JM, Alfageme I, Almagro P, et al. Multicomponent indices to predict survival in COPD: the COCOMICS study. Eur Respir J 2013; 42: 323-332.
Soler-Cataluña JJ, Martínez-García MA, Román, et al. Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax 2005; 60: 925-931.
Alfageme I, Reyes N, Merino M, et al. The effect of airflow limitation on the cause of death in patients with COPD. Chronic Respir Dis 2010; 7: 135-145.
Casanova C, Cote C, de Torres JP, et al. Inspiratory-to-total lung capacity ratio predicts mortality in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2005; 171: 591-597.
Marín JM, Soriano JB, Carrizo SJ, et al. Outcomes in patients with chronic obstructive pulmonary disease and obstructive sleep apnea. Am J Respir Crit Care Med 2010; 182: 325-331.
Almagro P, Calbo E, Ochoa de Echagüen A, et al. Mortality after hospitalization for COPD. Chest 2002; 121: 1441-1448.
Almagro P, Salvadó M, Garcia-Vidal C, et al. Recent improvement in long-term survival after a COPD hospitalisation. Thorax 2010; 65: 298-302.
Zuur-Telgen MC, Brusse-Keizer MG, Vandervalk PD, et al. Stable state MR-proadrenomedullin level is a strong predictor of mortality in COPD patients. Chest 2013; 145: 534-541.
Crapo RO, Casaburi R, Coates AL, et al. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002; 166: 111-117.
Brusasco V, Crapo R, Viegi G, et al. Coming together: the ATS/ERS consensus on clinical pulmonary function testing. Eur Respir J 2005; 26: 1-2.
Morgenthaler NG, Morgenthaler NG, Struck J, et al. Assay for the measurement of copeptin, a stable peptide derived from the precursor of vasopressin. Clin Chem 2006; 52: 112-119.
Morgenthaler NG, Struck J, Jochberger S, et al. Copeptin: clinical use of a new biomarker. Trends Endocrinol Metabol 2008; 19: 43-49.
Rodriguez-Roisin R. Toward a consensus definition for COPD exacerbations. Chest 2000; 117: Suppl. 2, 398S-401S.
Cazzola M, MacNee W, Martinez FJ, et al. Outcomes for COPD pharmacological trials: from lung function to biomarkers. Eur Respir J 2008; 31: 416-469.
Tibshirani R. Regression shrinkage and selection via the lasso. J R Stat Soc Series B Stat Methodol 1996; 58: 267-288.
Steyerberg EW, Vickers AJ, Cook NR, et al. Assessing the performance of prediction models. Epidemiology 2010; 21: 128-138.
Landbo C, Prescott E, Lange P, et al. Prognostic value of nutritional status in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2012; 160: 1856-1861.
Hallin R, Gudmundsson G, Suppli Ulrik C, et al. Nutritional status and long-term mortality in hospitalised patients with chronic obstructive pulmonary disease (COPD). Respir Med 2007; 101: 1954-1960.
Rutten EPA, Calverley PMA, Casaburi R, et al. Changes in body composition in patients with chronic obstructive pulmonary disease: do they influence patient-related outcomes. Ann Nutr Metab 2013; 63: 239-247.
Schols A, Slangen J, Volovics L, et al. Weight loss is a reversible factor in the prognosis of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2012; 157: 1791-1797.
Prescott E, Almdal T, Mikkelsen KL, et al. Prognostic value of weight change in chronic obstructive pulmonary disease: results from the Copenhagen City Heart Study. Eur Respir J 2002; 20: 539-544.
World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation (World Health Organization technical report series 894). WHO, Geneva, 2000. Available from: www.who.int/nutrition/publications/obesity/WHO-TRS-894/en/
Connors AF, Dawson NV, Thomas C, et al. Outcomes following acute exacerbation of severe chronic obstructive lung disease. Am J Respir Crit Care Med 1996; 154: 959-967.
Groenewegen KH, Schols A, Wouters EF. Mortality and mortality-related factors after hospitalization for acute exacerbation of COPD. Chest 2003; 124: 459-467.
Agusti A, Edwards LD, Celli B, et al. Characteristics, stability and outcomes of the 2011 GOLD COPD groups in the ECLIPSE cohort. Eur Respir J 2013; 42: 636-646.
Soler-Cataluña JJ, Martínez-García MA, Sánchez LS, et al. Severe exacerbations and BODE index: two independent risk factors for death in male COPD patients. Respir Med 2009; 103: 692-699.
Nishimura K, Izumi T, Tsukino M, et al. Dyspnea is a better predictor of 5-year survival than airway obstruction in patients with COPD. Chest 2002; 121: 1434-1440.
Bestall JC, Paul EA, Garrod R, et al. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 1999; 54: 581-586.
Lange P, Marott JL, Vestbo J, et al. Prediction of the clinical course of chronic obstructive pulmonary disease, using the new GOLD classification. Am J Respir Crit Care Med 2012; 186: 975-981.
Cote CG, Dordelly LJ, Celli BR. Impact of COPD exacerbations on patient-centered outcomes. Chest 2007; 131: 696-704.
Raff H, Shinsako J, Keil LC, et al. Vasopressin, ACTH, and corticosteroids during hypercapnia and graded hypoxia in dogs. Am J Physiol 1983; 244: E453-E458.
Schrier RW, Berl T, Anderson RJ. Osmotic and nonosmotic control of vasopressin release. Am J Physiol 1979; 236: F321-F332.
Raff H, Kane CW, Wood CE. Arginine vasopressin responses to hypoxia and hypercapnia in late-gestation fetal sheep. Am J Physiol 1991; 260: R1077-R1081.
Stolz D, Christ-Crain M, Morgenthaler NG, et al. Copeptin, C-reactive protein, and procalcitonin as prognostic biomarkers in acute exacerbation of COPD. Chest 2007; 131: 1058-1067.
Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD. Eur Respir J 2009; 33: 1165-1185.
Fabbri LM, Luppi F, Beghé B, et al. Complex chronic comorbidities of COPD. Eur Respir J 2008; 31: 204-212.
Camiciottoli G, Bigazzi F, Bartolucci M, et al. BODE-index, modified BODE-index and ADO-score in chronic obstructive pulmonary disease: relationship with COPD phenotypes and CT lung density changes. COPD 2012; 9: 297-304.
Han MK, Muellerova H, Curran-Everett D, et al. GOLD 2011 disease severity classification in COPDGene: a prospective cohort study. Lancet Respir Med 2013; 1: 43-50.
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