Servicio de Neumolog.ía, Hospital Universitario Lucus Augusti. Lugo, Spain; Grupo C039 Biodiscovery HULA-USC, Instituto de Investigaci..n Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
Servicio de Neumolog.ía, Hospital Galdakao-Usansolo, Bizkaia, Spain; Red de Investigaci..n en Servicios de Salud en Enfermedades Cr..nicas (REDISSEC), Hospital Galdakao-Usansolo, Bizkaia, Spain.
Pulmonology. 2023 Jul-Aug;29(4):276-283. doi: 10.1016/j.pulmoe.2020.10.008. Epub 2020 Dec 4.
Several multidimensional indices have been proposed to predict mortality in chronic obstructive pulmonary disease (COPD). The BODEX index is simple and easy to use for this purpose in all clinical settings. Only a few prognostic indices have integrated oxygenation variables, with measurement methods that are not practical for real life clinical practice in all settings.
To develop and externally validate a new prognostic index (BODEXS90) that combines the variables included in BODEX index with rest peripheral oxygen saturation measured with finger oximetry (SpO) to predict all-cause mortality in stable COPD.
Observational, non-intervention, multicenter historic cohort study. The BODEXS90 index was developed in a derivation cohort and externally validated in a validation cohort. Calibration of the index was carried out using Hosmer-Lemeshow test. The discrimination capacity of BODEXS90 and BODEX were compared by means of receiver-operating characteristics curves. Modelling of the index was carried out by crude and adjusted Cox regression analysis.
The derivation and validation cohorts included 787 and 1179 subjects, respectively. SpO predicted all cause-mortality independently of BODEX index. Discrimination capacity of BODEXS90 to predict the outcome was significantly higher than that of BODEX, particularly for more severely affected patients, both in the derivation and in the validation cohorts.
The new index is potentially useful for designing clinical decision-making algorithms in stable COPD.
已有多种多维指数被提出用于预测慢性阻塞性肺疾病（COPD）的死亡率。BODEX 指数在所有临床环境中都非常简单易用，可用于此目的。只有少数预后指数整合了氧合变量，但其测量方法在所有环境下的实际临床实践中并不实用。
开发和外部验证一种新的预后指数（BODEXS90），该指数将 BODEX 指数中包含的变量与手指血氧饱和度计测量的静息外周氧饱和度（SpO）相结合，以预测稳定 COPD 患者的全因死亡率。
观察性、非干预性、多中心历史队列研究。在推导队列中开发 BODEXS90 指数，并在验证队列中进行外部验证。通过 Hosmer-Lemeshow 检验对指数进行校准。通过接收者操作特征曲线比较 BODEXS90 和 BODEX 的区分能力。通过粗回归和调整 Cox 回归分析对指数进行建模。
推导队列和验证队列分别纳入 787 例和 1179 例患者。SpO 独立于 BODEX 指数预测全因死亡率。在推导队列和验证队列中，BODEXS90 预测结局的区分能力均显著高于 BODEX，尤其是在病情更严重的患者中。
新指数对于设计稳定 COPD 的临床决策算法具有潜在的应用价值。
