Cote C G, Celli B R
Division of Pulmonary-Critical Care Medicine, The Bay Pines Foundation, Bay Pines VA Medical Center, University of South Florida, Tampa, USA.
Eur Respir J. 2005 Oct;26(4):630-6. doi: 10.1183/09031936.05.00045505.
The BODE index, which integrates body mass index, airflow limitation (forced expiratory volume in one second), dyspnoea and 6-min walk distance, predicts mortality in chronic obstructive pulmonary disease (COPD). Pulmonary rehabilitation (PR) improves some components of BODE. It was hypothesised that changes in BODE may reflect the effects of PR. To test this, participation in PR was offered to 246 patients (BODE quartiles 2-4). The patients were divided as follows: no PR (130 who declined rehabilitation or who dropped out from PR), and PR (116 who completed PR). BODE was determined at entry, after PR, and at 1 and 2 yrs. Other outcomes were: length of stay (LOS) for respiratory-related hospitalisations and mortality. At entry, the two groups had similar age and comorbidity but different BODE. After PR, the BODE improved by 19% and returned to baseline after 2 yrs. The BODE worsened in the no PR group by 4% at 12 months and 18% at 2 yrs. Respiratory mortality at 2 yrs for PR was 7%, compared with 39% for no PR. LOS at 1 yr for COPD decreased 20% in PR, while it increased 25% in no PR. In conclusion, pulmonary rehabilitation participation improves BODE and is associated with better outcomes. The BODE index change after pulmonary rehabilitation provides valuable prognostic information.
BODE指数综合了体重指数、气流受限（一秒用力呼气容积）、呼吸困难和6分钟步行距离，可预测慢性阻塞性肺疾病（COPD）的死亡率。肺康复（PR）可改善BODE的某些组成部分。据推测，BODE的变化可能反映了PR的效果。为了验证这一点，我们为246例患者（BODE四分位数2 - 4）提供了参与PR的机会。患者被分为以下两组：未接受PR组（130例拒绝康复治疗或退出PR的患者）和PR组（116例完成PR的患者）。在入组时、PR后、1年和2年时测定BODE。其他结果包括：与呼吸相关的住院时间（LOS）和死亡率。入组时，两组患者年龄和合并症相似，但BODE不同。PR后，BODE改善了19%，2年后恢复到基线水平。未接受PR组的BODE在12个月时恶化了4%，2年后恶化了18%。PR组2年时的呼吸死亡率为7%，而未接受PR组为39%。PR组中COPD患者1年时的LOS下降了20%，而未接受PR组则增加了25%。总之，参与肺康复可改善BODE，并与更好的结果相关。肺康复后BODE指数的变化提供了有价值的预后信息。
