Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 8

A comparison of three multidimensional indices of COPD severity as predictors of future exacerbations

Authors Motegi T, Jones RC, Ishii T, Hattori K, Kusunoki Y, Furutate R, Yamada K, Gemma A, Kida K

Received 15 January 2013

Accepted for publication 22 March 2013

Published 31 May 2013 Volume 2013:8 Pages 259—271


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 6

Takashi Motegi,1,2 Rupert C Jones,3 Takeo Ishii,1,2 Kumiko Hattori,1,2 Yuji Kusunoki,1,2 Ryuko Furutate,2 Kouich Yamada,1,2 Akihiko Gemma,1 Kozui Kida1,2

1Divisions of Pulmonary Medicine, Infectious Disease, and Oncology, Department of Internal Medicine, 2Respiratory Care Clinic, Nippon Medical School, Tokyo, Japan; 3Respiratory Research Unit, Peninsula Medical School, Plymouth, UK

Background: Prediction of future exacerbations of chronic obstructive pulmonary disease (COPD) is a major concern for long-term management of this disease.
Aim: To determine which of three multidimensional assessment systems (the body mass index, obstruction, dyspnea, and exercise capacity [BODE] index; dyspnea, obstruction, smoking, exacerbations [DOSE] index; or age, dyspnea, obstruction [ADO] index) is superior for predicting exacerbations.
Methods: This was a 2-year prospective cohort study of COPD patients. Pulmonary function tests, the 6-minute walk distance (6MWD), Modified Medical Respiratory Council (MMRC) dyspnea scores, chest computed-tomography measurements, and body composition were analyzed, and predictions of exacerbation by the three assessment systems were compared.
Results: Among 183 patients who completed the study, the mean annual exacerbation rate was 0.57 events per patient year, which correlated significantly with lower predicted forced expiratory volume in 1 second (FEV1) (P < 0.001), lower transfer coefficient of the lung for carbon monoxide (%DLco/VA) (P = 0.021), lesser 6MWD (P = 0.016), higher MMRC dyspnea score (P = 0.001), higher DOSE index (P < 0.001), higher BODE index (P = 0.001), higher ADO index (P = 0.001), and greater extent of emphysema (P = 0.002). For prediction of exacerbation, the areas under the curves were larger for the DOSE index than for the BODE and ADO indices (P < 0.001). Adjusted multiple logistic regression identified the DOSE index as a significant predictor of risk of COPD exacerbation.
Conclusion: In this study, the DOSE index was a better predictor of exacerbations of COPD when compared with the BODE and ADO indices.

Keywords: frequency of exacerbation, multidimensional assessment systems, DOSE index, BODE index

A Letter to the Editor has been received and published for this article.

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]


Readers of this article also read:

Evaluation of the COPD Assessment Test and GOLD patient types: a cross-sectional analysis

Lopez-Campos JL, Fernandez-Villar A, Calero-Acuña C, Represas-Represas C, Lopez-Ramírez C, Fernández VL, Soler-Cataluña JJ, Casamor R

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:975-984

Published Date: 27 May 2015

Effect of N-acetylcysteine in COPD patients with different microsomal epoxide hydrolase genotypes

Zhang JQ, Zhang JQ, Liu H, Zhao ZH, Fang LZ, Liu L, Fu WP, Shu JK, Feng JG, Dai LM

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:917-923

Published Date: 13 May 2015

Detection of acute deterioration in health status visit among COPD patients by monitoring COPD assessment test score

Pothirat C, Chaiwong W, Limsukon A, Deesomchok A, Liwsrisakun C, Bumroongkit C, Theerakittikul T, Phetsuk N

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:277-282

Published Date: 3 February 2015

The mediating role of cytokine IL-6 on the relationship of FEV1 upon 6-minute walk distance in chronic obstructive pulmonary disease

Baldi S, Jose PE, Bruschi C, Pinna GD, Maestri R, Rezzani A, Bellinzona E, Fracchia C, Dacosto E, Crotti P, Montemartini S

International Journal of Chronic Obstructive Pulmonary Disease 2014, 9:1091-1099

Published Date: 7 October 2014

Chronic obstructive pulmonary disease exacerbation frequency and severity

Stafyla E, Kerenidi T, Gourgoulianis KI

International Journal of Chronic Obstructive Pulmonary Disease 2013, 8:533-535

Published Date: 6 November 2013

The 6-minute pegboard and ring test is correlated with upper extremity activity of daily living in chronic obstructive pulmonary disease

Takeda K, Kawasaki Y, Yoshida K, Nishida Y, Harada T, Yamaguchi K, Ito S, Hashimoto K, Matsumoto S, Yamasaki A, Igishi T, Shimizu E

International Journal of Chronic Obstructive Pulmonary Disease 2013, 8:347-351

Published Date: 23 July 2013

Symptom variability in COPD: a narrative review

Lopez-Campos JL, Calero C, Quintana-Gallego E

International Journal of Chronic Obstructive Pulmonary Disease 2013, 8:231-238

Published Date: 7 May 2013