Thursday, September 20, 2007

The BODE Index - A Multidimensional Grading System To Assess COPD

The Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity Index in Chronic Obstructive Pulmonary Disease (BODE Index)

N Engl J Med 2004;350:1005-12. (pdf file)

Chronic obstructive pulmonary disease (COPD), a common disease characterized by a poorly reversible limitation in airflow, is predicted to be the third most frequent cause of death in the world by 2020. The risk of death in patients with COPD is often graded with the use of a single physiological variable, the forced expiratory volume in one second (FEV1). However, other risk factors, such as the presence of hypoxemia or hypercapnia, a short distance walked in a fixed time, a high degree of functional breathlessness, and a low body-mass index (the weight in kilograms divided by the square of the height in meters), are also associated with an increased risk of death. This is a multidimensional grading system that assessed the respiratory, perceptive, and systemic aspects of COPD that would better categorize the illness and predict the outcome than does the FEV1 alone.

You can read the rest of the article and view the assessment scale here.

as a personal note, since I recently had PFTs done and a six minute walk, (besides knowing how tall I am and how much I weigh...) I was able to use the "plug in your numbers, get your score" form on the site.
According to my BODE, I have an 82% chance of being alive in four years.
Good odds, I agree, and a good thing, since I'm planning on it regardless of any "score."

On the other hand, I could fall into the river and get swept into the sea tomorrow.
Not likely, given our lack of rain this season, but you get my point.

And if my score had been lower? A lot lower? Someday it will be (some day everyone alive's will be). Maybe your score is pretty low now?

Here's what I think.
I think it's worth paying attention to, so that we can take good care of ourselves, follow up with good medical care, and try our best to avoid infections this winter.
But I really think that attitude, motivation, faith and a willingness to "keep on keeping on" (thanks, Tony) is a much better indicator of how you're going to fare over the next four years.

All of that being said -
here's that link again.