Mortality in a recent study of 625 patients with chronic obstructive pulmonary disease compared with results of 3...

To assess comparative mortality in COPD patients by severity in a recent study with results in 3 older studies.

Analysis is made of a recent multicenter study (7 clinics in the United States, Spain, and Venezuela) of COPD patients. An evaluation cohort of 207 patients was utilized to establish a scoring system based on body mass index (B), airflow obstruction (O--measured by FEV1, forced expiratory volume at 1 second), dyspnea (D), and exercise capacity (E). A scoring system for each of these 4 severity factors led to the development of the BODE Index, with a range of 0-10. This index was shown to produce a wider range of mortality than staging (1 to 3) by the FEV1 alone.

From the FEV1 Stage and the BODE Index data, a validation cohort of 625 COPD patients was observed for 52 months. This follow-up showed a wider range of mortality by the BODE Index than that obtained by use of FEV1 staging alone. This recent experience (1997-2002) is compared with results of 3 previously published mortality studies of COPD.

Incorporation of additional severity factors such as dyspnea and exercise capacity improves the prediction of mortality by severity of the COPD, as compared with the use of FEV1 staging alone. Mortality remains at a very high level in all cases, except for those with the mildest form of COPD.