Prediction of risk of COPD exacerbations by the BODE index

Respir Med. 2009 Mar;103(3):373-8. doi: 10.1016/j.rmed.2008.10.004. Epub 2008 Nov 17.


Objectives: This study assesses the power of the BODE index, a multidimensional grading system that predicts mortality, to predict subsequent exacerbations in patients with COPD.

Design: Prospective cohort study.

Patients and interventions: A total of 275 COPD patients were followed every 6 months up to 8 years (median of 5.1 years). Baseline clinical variables were recorded and the BODE index was calculated. We investigated the prognostic value of BODE quartiles (scores 0-2, 3-4, 5-6 and 7-10) for both the number and severity of exacerbations requiring ambulatory treatment, emergency room visit, or hospitalization.

Results: The annual rate of COPD exacerbations was 1.95 (95% CI, 0.90-2.1). The mean time to a first exacerbation was inversely proportional to the worsening of the BODE quartiles (7.9 yrs, 5.7 yrs, 3.4 yrs and 1.3 yrs for BODE scores of 0-2, 3-4, 5-6 and 7-10, respectively). Similarly, the mean time to a first COPD emergency room visit was 6.7 yrs, 3.6 yrs, 2.0 yrs and 0.8 yrs for BODE quartiles (all p<0.05). Using ROC curves, the BODE index was a better predictor of exacerbation than the FEV(1) alone (p<0.01).

Conclusions: The BODE index is a better predictor of the number and severity of exacerbations in COPD than FEV(1) alone.

Publication types

  • Multicenter Study

MeSH terms

  • Activities of Daily Living
  • Aged
  • Area Under Curve
  • Cohort Studies
  • Emergencies
  • Exercise Tolerance
  • Female
  • Forced Expiratory Volume
  • Health Status
  • Hospitalization
  • Humans
  • Lung / physiopathology*
  • Male
  • Middle Aged
  • Prognosis
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Recurrence
  • Risk Assessment / methods
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Time Factors