BODE-Index vs HADO-score in chronic obstructive pulmonary disease: Which one to use in general practice?
BACKGROUND
Forced expiratory volume in one second (FEV1) is used to diagnose and establish a prognosis in chronic obstructive pulmonary disease (COPD). Using multi-dimensional scores improves this predictive capacity.Two instruments, the BODE-index (Body mass index, Obstruction, Dyspnea, Exercise capacity) and the HADO-score (Health, Activity, Dyspnea, Obstruction), were compared in the prediction of mortality among COPD patients.


METHODS
This is a prospective longitudinal study. During one year (2003 to 2004), 543 consecutively COPD patients were recruited in five outpatient clinics and followed for three years. The endpoints were all-causes and respiratory mortality.


RESULTS
In the multivariate analysis of patients with FEV1 < 50%, no significant differences were observed in all-cause or respiratory mortality across HADO categories, while significant differences were observed between patients with a lower BODE (less severe disease) and those with a higher BODE (greater severity). Among patients with FEV1 > or = 50%, statistically significant differences were observed across HADO categories for all-cause and respiratory mortality, while differences were observed across BODE categories only in all-cause mortality.


CONCLUSIONS
HADO-score and BODE-index were good predictors of all-cause and respiratory mortality in the entire cohort. In patients with severe COPD (FEV1 < 50%) the BODE index was a better predictor of mortality whereas in patients with mild or moderate COPD (FEV1 > or = 50%), the HADO-score was as good a predictor of respiratory mortality as the BODE-index. These differences suggest that the HADO-score and BODE-index could be used for different patient populations and at different healthcare levels, but can be used complementarily.
Esteban
Cristóbal
C
Pneumology Department, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain. cristobal_esteban@yahoo.es
Quintana
José M
JM
Moraza
Javier
J
Aburto
Myriam
M
Aguirre
Urko
U
Aguirregomoscorta
José I
JI
Aizpiri
Susana
S
Basualdo
Luis V
LV
Capelastegui
Alberto
A
D000368:Aged; D005194:Family Practice / Q000379:methods*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D012720:Severity of Illness Index; D016019:Survival Analysis