Prognostic assessment in COPD: Health related quality of life and the BODE index

Rationale: COPD is a debilitating disease with increasing mortality worldwide. The BODE index evaluates disease severity and the St George's Respiratory Questionnaire (SGRQ) measures health status. Objective: To identify the relationship between BODE index and the SGRQ and to test the predictive value of both tools against survival. Methods: Open cohort study of 1398 COPD patients (85% male) followed for up to 10 years. Measurements and main results: At the time of the inclusion, clinical data, forced spirometry and 6 min walking distance were determined and BODE index and SGRQ were calculated. Vital status and cause of death were documented at the end of follow-up. Results: The cohort's mean of FEV1% predicted was 46 +/- 18%, BODE index was 3.6 +/- 2.5, and SGRQ% total score was 49 +/- 20. The SGRQ scores increased progressively as severity of COPD increased by BODE quartiles. The correlation between SGRQ and BODE index was good (r = 0.58, p < 0.0001). Both tests correlated with COPD survival (BODE = -0.4 vs. SGRQ = -0.20, p < 0.0001). The area under the curve (AUC) for the BODE index was 0.77 vs. 0.66 for the SGRQ% total score (p < 0.001). Conclusions: Health status as measured by SGRQ worsens with disease severity evaluated by the BODE index. Both tools predict mortality and provide complimentary information in the evaluation of patients with COPD. (C) 2011 Elsevier Ltd. All rights reserved.