ABSTRACT
Chronic obstructive pulmonary disease (COPD) is a highly prevalent disease. Currently, severity Global initiative for chronic Obstructive Lung Disease (GOLD) criteria are used to diagnose the severity of COPD, but a new grading system, the body mass index, bronchial obstruction, dyspnea, exercise (BODE) index, was recently proposed to provide useful prognostic information. The objective of this study is to evaluate the association between health-related quality of life (HRQOL) and COPD severity assessed by two criteria: the GOLD classification and the BODE index. Sixty-four patients with COPD were examined with lung function tests and specific and generic HRQOL questionnaires (St. George's Respiratory Questionnaire [SGRQ], Nottingham Health Profile [NHP]). Participants were divided into four severity groups using the GOLD guidelines and the BODE index quartiles. The association between NHP and SGRQ subscales, and the BODE index was significant (P < 0.01). However, the GOLD classification shows a correlation only with SGRQ total score (P < 0.05) but not with NHP or SGRQ subscales. There was an association of the SGRQ total score between the severity groups of BODE (P = 0.0001), but there was no difference in the SGRQ total score between the severity groups of GOLD classification (P = 0.244). The present study suggests that COPD severity assessed by the BODE index can be more directly related with HRQOL.
Subject(s)
Health Status , Pulmonary Disease, Chronic Obstructive/diagnosis , Quality of Life , Severity of Illness Index , Surveys and Questionnaires , Aged , Aged, 80 and over , Body Mass Index , Cross-Sectional Studies , Exercise Tolerance/physiology , Female , Humans , Male , Middle Aged , Prognosis , Pulmonary Disease, Chronic Obstructive/physiopathology , Pulmonary Disease, Chronic Obstructive/psychology , Reproducibility of Results , Respiratory Function TestsABSTRACT
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is currently the fourth cause of mortality and morbility in the developed world. Patients with COPD experience a progressive deterioration of health-related quality of life (HRQOL). A new model of severity classification, the body mass index, bronchial obstruction, dyspnoea, exercise (BODE) index, has recently been proposed. OBJECTIVE: To evaluate the relationship between HRQOL and the BODE index, and the predictive ability of BODE on HRQOL measurements. METHODS: Two HRQOL questionnaires were administered, namely the Nottingham Health Profile (NHP) and St George's Respiratory Questionnaire (SGRQ), in a sample of 67 patients with severe COPD. RESULTS: Pearsons correlation coefficient analysis shows a positive correlation between the BODE index and the total scores of the specific (P < 0.001), and general HRQOL (P < 0.001); the analysis shows a significant correlation between the BODE index and the subscales of symptoms, activity and impact of SGRQ (P < 0.001) and the subscales energy and physical mobility of the NHP (P < 0.001). The regression analysis shows that the BODE index is a significant predictor of HRQOL, explaining 46,1% of the total score of the SGRQ (P < 0.001) and 14.8% of the total score of the NHP (P < 0.001). CONCLUSIONS: The BODE index is good at predicting the worsening of HRQOL in patients with severe COPD.
