BODE-Index vs HADO-Score in Chronic Obstructive Pulmonary Disease: Which one to use in general practiceReport as inadecuate




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BMC Medicine

, 8:28

First Online: 24 May 2010Received: 16 January 2010Accepted: 24 May 2010DOI: 10.1186-1741-7015-8-28

Cite this article as: Esteban, C., Quintana, J.M., Moraza, J. et al. BMC Med 2010 8: 28. doi:10.1186-1741-7015-8-28

Abstract

BackgroundForced expiratory volume in one second FEV1 is used to diagnose and establish a prognosis in chronic obstructive pulmonary disease COPD. Using multi-dimensional scores improves this predictive capacity.Two instruments, the BODE-index B ody mass index, O bstruction, D yspnea, E xercise capacity and the HADO-score H ealth, A ctivity, D yspnea, O bstruction, were compared in the prediction of mortality among COPD patients.

MethodsThis is a prospective longitudinal study. During one year 2003 to 2004, 543 consecutively COPD patients were recruited in five outpatient clinics and followed for three years. The endpoints were all-causes and respiratory mortality.

ResultsIn the multivariate analysis of patients with FEV1 < 50%, no significant differences were observed in all-cause or respiratory mortality across HADO categories, while significant differences were observed between patients with a lower BODE less severe disease and those with a higher BODE greater severity. Among patients with FEV1 ≥ 50%, statistically significant differences were observed across HADO categories for all-cause and respiratory mortality, while differences were observed across BODE categories only in all-cause mortality.

ConclusionsHADO-score and BODE-index were good predictors of all-cause and respiratory mortality in the entire cohort. In patients with severe COPD FEV1 < 50% the BODE index was a better predictor of mortality whereas in patients with mild or moderate COPD FEV1 ≥ 50%, the HADO-score was as good a predictor of respiratory mortality as the BODE-index. These differences suggest that the HADO-score and BODE-index could be used for different patient populations and at different healthcare levels, but can be used complementarily.

Abbreviations6MWT6-minute walking test

ATSAmerican Thoracic Society

AUCarea under the curve

BMIbody mass index

BODE-indexBody mass index, Obstruction, Dyspnea, Exercise capacity-index

COPDChronic Obstructive Pulmonary Disease

FEV1forced expiratory volume in one second

FVCForced Vital Capacity

HADO-scoreHealth, Activity, Dyspnea, Obstruction-score

ORodds ratio

SEPARSpanish Pneumology and Thoracic Surgery Society.

Electronic supplementary materialThe online version of this article doi:10.1186-1741-7015-8-28 contains supplementary material, which is available to authorized users.

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