The Value Of Individual Variables Of BODE Index And GOLD Spirometry In Stratifying The Severity Of COPD | 108246
Journal of Pulmonary & Respiratory Medicine
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Background: Chronic obstructive pulmonary disease (COPD) is a preventable and
treatable disease characterized by partially reversible airflow limitation. BODE index is
a multi-dimensional tool stands as pneumonic composing the four individual variables
[B-the body mass index (BMI), O-the degree of airway obstruction (post-bronchodilator
FEV1% predicted), D-Dyspnea scale and E- Exercise capacity measured by 6-minute
walk distance test (6M WDT)]; giving the total points of 10; divided into four quartiles.
It is used to diagnose, grade the severity, evaluate systemic comorbidities, evaluate the
response to intervention and predict the mortality due to the disease.
Purpose: The main purpose of this study is to assess the severity of COPD by using
BODE index and its individual variables, and GOLD stage; correlate their values to each
other and determine their validity in stratifying the severity of COPD.
Patients & Methods: A hospital based cross-sectional study was conducted among a
sampled 80 consecutive COPD patients visiting chest clinic of Jimma University Medical
Center (JUMC) located at Jimma town, South west Ethiopia; from May 18 to August 18,
2017 G.C; and the measurement of all individual variables of BODE index were performed
according to the American Thoracic Society (ATS), their results were entered into EPI
data (3.1) and exported to SPSS (20) for further analysis. Chi square (X2) test, Spearman
correlation, kappa measure of agreement, receiver operator characteristic (ROC) and area
under curve (AUC) was applied to determine the correlation and validity of variables/
tools in grading the severity of the disease.
Results: Eighty (80) COPD patients were enrolled in the study, Mean of Age
(55.1±13.66), BMI (19.98±3.43), 6M WDT (283±84.5), BODE index point (6.17±2.55),
FEV1% predicted (42.5±15.6) and Dyspnea scale (2.2±0.7) were achieved. Majority of
COPD patients were belonged to quartile IV, relatively increased through the stages if
classification was made by BODE index and its components (FEV1% predicted and 6M
WDT) but was higher among stage 3/severe if it was based on GOLD stage and dyspnea
score. All variables used to grade COPD were positively correlated with each other except
with BMI score (inversely correlated). The validity of the variables/tools used in grading
severity of the disease was ranked as BODE index, 6M WDT, FEV1%, GOLD stage and
dyspnea score in descending order while BMI score had the least/poor validity to predict
the aim of the study based on specific results of their sensitivity, specificity, AUC with
95% CI and p-value.
Conclusion: All variables except BMI score were valid to predict severity of COPD.
Wondu Reta was graduated from Jimma University, Institute of Health in BSc degree in Junior Anesthesiology professional in June 2012 GC and Master’s degree in Medical Physiology in October 2017 G.C. He was currently serving Jimma University, Institute of health as Anesthesia care provider, researcher and lecturer of Medical Physiology and Anesthesiology. He was also reviewing different papers related to his professionals on different journals