Study on Prognostic Evaluation of COPD Patients Using BODE Index

Md. Siddiqur Rahman, HN Sarker, Nasreen Haque,Md. Abdur Rouf, Bipul Kanti Biswas

Abstract:
Background: Chronic obstructive pulmonary disease (COPD) is a common
disease characterized by airflow limitation which is irreversible or partially
reversible. The risk of death in patients with COPD is traditionally graded with
the use of the forced expiratory volume in one second (FEV1), but it correlates
better with the BODE index.
Objective: The aims of this study were to assess that component of BODE index
have more impact on mortality of COPD patients than post bronchodilator FEV1
& to see the relative contributions of respiratory& non-respiratory causes of death
in COPD patients.
Methods & Materials: It was a prospective study during the period of July 2010
to June 2014 was conducted in outpatient at Sher-E-Bangla Medical College
Hospital, Barisal, Bangladesh.. Total 252 patients were included who were COPD.
Results: Among the study population of 252,188(74.60%) were male & 64(25.39%)
were female and 188(74.60%) patients were smokers and 64(25.39%) nonsmokers.
Out of 188 smokers 176(69.84%) were male & 12(04.76%) were female. Out of 64
nonsmokers, 8(12.50%) were male and 56(87.50%) were female who were exposed
to biomass fuel while cooking.We assessed the severity of COPD in each patient
at the beginning according to ATS guideline. Most of the study population-
188(74.60%) were in stage III COPD. During the study period of 48 months (4yrs),
52(20.65%) patients died out of 252. All patients who died, had BODE score point
10 i.e. in 4th Quartile.Out of 52 deaths 28(53.84% of death) died from respiratory
causes (corpulmonale and respiratory failure) &24(46.15% of the death) died from
non-respiratory causes (like malignancy, IHD and complications of HTN).
Conclusion: A recognizable number of patients suffer from COPD due to exposure
of Biomass fuel particularly females of Bangladesh. The higher the BODE score
points, higher the risk of death from respiratory causes. Co-morbidities are
accountable for the death of COPD patients in addition to variables in BODE index.
Clinical implication: COPD is a heterogeneous disease without a simple
prognostic trajectory. Co-morbidities & exacerbations contribute to the overall
severity in individual patients. The BODE index measures functional limitation,
nutritional status and symptoms, in addition to airflow obstruction, and is
therefore well placed to assess clinical risk and the integrated response to treatment.
Key words: COPD, Prognosis, BODE index.

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