title: High value of combined serum C-reactive protein and BODE score for mortality prediction in patients with stable COPD.
abstract: BACKGROUND
  Both BODE score (body mass index, degree of airflow obstruction, functional dyspnea, and exercise capacity) and serum C-reactive protein (CRP) are validated predictors of mortality in patients with chronic obstructive pulmonary disease (COPD). The aim of this study is to investigate the predictive value of combined serum CRP and BODE score for mortality in COPD patients.
  
  
  METHODS
  A cohort of 114 clinically stable COPD patients was assessed for predictors of longitudinal mortality. Variables included age, gender, current smoking status, pack-years, maximal inspiratory/expiratory pressure, BODE score (body mass index, degree of airflow obstruction, functional dyspnea, and exercise capacity), serum CRP, and fibrinogen. Predictors were assessed by Cox proportional hazards regression model. Survival was estimated by Kaplan-Meier method and log-rank test.
  
  
  RESULTS
  Serum CRP (P=0.005; HR=1.042; 95% CI=1.019-1.066) and BODE score (P=0.032; HR=1.333; 95% CI=1.025-1.734) were independent predictors of survival in the multivariate analysis. The cumulative survival rates of COPD patients were sorted from the worst to the best as following: serum CRP >3mg/L & quartile 3-4; serum CRP >3mg/L & quartile 1-2; serum CRP ≤3mg/L & quartile 3-4; serum CRP ≤3mg/L & quartile 1-2 (P<0.001).
  
  
  CONCLUSIONS
  Serum CRP and BODE score are independent predictors of survival in stable COPD patients. Combination of serum CRP and BODE score has higher predictive value in clinical practice.
authors.affiliation: Division of Pulmonary & Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwán, China. mengchih@adm.cgmh.org.tw
authors.forename: Shih-Feng
authors.initials: SF
authors.lastname: Liu
authors.forename: Chin-Chou
authors.initials: CC
authors.lastname: Wang
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Chin
authors.forename: Yung-Che
authors.initials: YC
authors.lastname: Chen
authors.forename: Meng-Chih
authors.initials: MC
authors.lastname: Lin
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D004417:Dyspnea / Q000209:etiology; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D012720:Severity of Illness Index; D015996:Survival Rate
chemical_list: D002097:C-Reactive Protein