Esteban Cristóbal, Aguirre Nere, Aramburu Amaia, Moraza Javier, Chasco Leyre, Aburto Myriam, Aizpiri Susana, Golpe Rafael, Quintana José M
Respiratory Department, Hospital Universitario Galdakao-Usansolo, Galdakao, Spain.
BioCruces-Bizkaia Health Research Institute, Baracaldo, Spain.
ERJ Open Res. 2024 Jan 15;10(1). doi: 10.1183/23120541.00488-2023. eCollection 2024 Jan.
The aim of this study was to create a prognostic instrument for COPD with a multidimensional perspective that includes physical activity (PA). The score also included health status, dyspnoea and forced expiratory volume in 1 s (HADO.2 score).
A prospective, observational, non-intervention study was carried out. Patients were recruited from the six outpatient clinics of the respiratory service of a single university hospital. The component variables of the HADO.2 score and BODE index were studied, and PA was measured using an accelerometer. The outcomes for the HADO.2 score were mortality and hospitalisations during follow-up and an exploration of the correlation with health-related quality of life at the moment of inclusion in the study.
401 patients were included in the study and followed up for three years. The HADO.2 score showed good predictive capacity for mortality: C-index 0.79 (0.72-0.85). The C-index for hospitalisations was 0.72 (0.66-0.77) and the predictive ability for quality of life, as measured by R2, was 0.63 and 0.53 respectively for the Saint George's Respiratory Questionnaire and COPD Assessment Test.
There was no statistically significant difference between the mortality predictive capacity of the HADO.2 score and the BODE index. Adding PA to the original BODE index significantly improved the predictive capacity of the index. The HADO.2 score, which includes PA as a key variable, showed good predictive capacity for mortality and hospitalisations. There were no differences in the predictive capacity of the HADO.2 score and the BODE index.
本研究旨在从多维度视角创建一种包含身体活动（PA）的慢性阻塞性肺疾病（COPD）预后评估工具。该评分还包括健康状况、呼吸困难和一秒用力呼气容积（HADO.2评分）。
开展了一项前瞻性、观察性、非干预性研究。患者从一家大学医院呼吸科的六个门诊招募。研究了HADO.2评分和BODE指数的组成变量，并使用加速度计测量PA。HADO.2评分的结局指标为随访期间的死亡率和住院率，以及在纳入研究时与健康相关生活质量的相关性探索。
401例患者纳入研究并随访三年。HADO.2评分对死亡率显示出良好的预测能力：C指数为0.79（0.72 - 0.85）。住院率的C指数为0.72（0.66 - 0.77），以R2衡量生活质量的预测能力，圣乔治呼吸问卷和慢性阻塞性肺疾病评估测试分别为0.63和0.53。
HADO.2评分和BODE指数在死亡率预测能力上无统计学显著差异。在原BODE指数中加入PA显著提高了该指数的预测能力。包含PA作为关键变量的HADO.2评分对死亡率和住院率显示出良好的预测能力。HADO.2评分和BODE指数的预测能力无差异。
