[The BODE index as a predictor of unfavourable prognosis in chronic obstructive pulmonary disease (by the results of a prospective study)].

AIM

To determine the death risk factors in patients with chronic obstructive pulmonary disease (COPD) in the course of a follow-up and to study feasibility of BODE index use for prognosis in COPD patients.

MATERIAL AND METHODS

A total of 86 COPD patients were followed up for 3-5 years. The examination included total blood count, ECG, estimation of body mass index, external respiration function, pulsoxymetry, measurement of dyspnea characteristics by MMRC scale, physical activity by a 6-min walk test. Within the follow-up time 19 patients died, 15 of them of the basic disease and its complications.

RESULTS

The death risk was higher in elderly patients over 60 years of age with dyspnea duration over 10 years and smoking history over 40 years (> 50 packs/year). In COPD death risk prediction factors are the following: forced expiration volume for 1 second under 40%, SaO2 < 90%, the result of 6-min walk test < 300 m, systolic pressure in the pulmonary artery above 40 mmHg, right ventricular (RV) wall thickness > 0.7 cm, R V cavity size > 3.0 cm, relative delatation of the right atrium (index < 0.9), R V diastolic dysfunction, symptoms of circulatory decompensation, predisposition to a hyperkinetic type of circulation. When BODE index was compared to the above data, its reliability as a factor of death prognosis in COPD was higher.

CONCLUSION

BODE index can be used as a simple integrative index of death risk in COPD.