The BODE index is used as a tool to refer or list COPD patients for lung transplantation (LTx). However, the original publication by Celli et al did not assess the influence of age or smoking status on the predictive value of the BODE index for survival. Since only ex-smokers aged less than 65 are generally considered for LTx, the present study assessed the added value of using age and smoking status at the time of BODE index assessment to predict survival in COPD patients. The BODE index was assessed as a routine in COPD patients followed in a tertiary care hospital with a LTx program. The files of consecutive patients with a BODE index assessment were reviewed for age and smoking status at the time of BODE index as well as for survival status. Patients were censored at the time of last contact or lung transplant. The impact of BODE index, age and smoking status on survival was assessed with a Cox regression analysis. The files of 469 consecutive patients (mean age: 63; males: n = 290) were reviewed. There were 324 ex smokers and 294 patients aged <65. There were 206, 197, 184, 138 patients in the BODE index quartiles 1-4. Mean follow-up time was 46 months. 138 patients died before LTx; mean time from BODE index assessment: 37 months. The Cox regression analysis showed that the BODE index (whether expressed as a continuous variable or as Quartile 1-4) as well as the age at the time of BODE index assessment (expressed as an ordinal variable: <65 or >65) were independently associated with survival (p<0,0001 for both). In patients with a BODE index in the 4th quartile aged less or more than 65, median survival was 54,7 and 39,3 months, respectively. Smoking status at the time of BODE index assessment did not significantly add to the survival prediction model that included BODE index and age (p 0,45 and 0,33 whether BODE index expressed as continuous or ordinal variable, respectively). In conclusion, age significantly adds to the BODE index in the prediction of survival in COPD patients. More data collected in patients less than 65 years old would be helpful to guide LTx referral and listing on the basis of the BODE index.
|Publication status||Published - May 2017|
|Event||American Thoracic Society 2017 International Conference - Washington DC, United States|
Duration: 19 May 2017 → 24 May 2017
|Conference||American Thoracic Society 2017 International Conference|
|Period||19/05/17 → 24/05/17|