The main finding of this study is that the BODE staging system, which includes in addition to FEVj other physiologic and clinical variables, helps to better predict hospitalization in patients with COPD. COPD is a complex multidimensional disease, and classification schemes that incorporate more parameters than the degree of are likely to predict outcomes more accurately. FEV1 is known to correlate poorly with symptoms, quality of life, exacerbation frequency, and exercise in-tolerance. Hence, newer approaches to disease assessment are required and may even supercede the current FEV1-based system of classification of disease severity. The multistage scoring system used in this study incorporates variables that can be easily evaluated in any office setting, and the BODE index has potential widespread applicability, just like the FEV1. Important to the acceptance for [...]
One hundred twenty-seven patients were followed up. The baseline characteristics of these patients are shown in Table 1. The mean age ± SD was 70.9 ± 8.2 years, and mean FEV1 was 43.7% of predicted. The number of patients in stages I to IV of COPD severity as defined by GOLD and the median BODE scores of the patients in each category are shown in Table 2. The vast majority of patients had moderate-to-very severe COPD (stages II to IV). The median BODE scores were progressively higher from stage I to stage IV. Table 3 shows the classification of patients according to BODE index score and individual variable scores. Patients in the cohort generally fared worse in airflow obstruction score than dyspnea and exercise capacity scores. Ten [...]
Between October 2002 and April 2004, patients with a wide range of severity of COPD, regardless of whether they had previous COPD hospital admissions or not, were recruited from a single institution and enrolled in the Health Service Development Program (HSDP) for COPD funded by the Ministry of Health, Singapore. This pilot service project provided several interventions—optimal medication, patient education, home care, and telephone support—and is aimed at reducing hospitalization for COPD. The main outcome measure monitored in this project was the frequency of hospital admissions for COPD. Patients were recruited from the outpatient clinic. A diagnosis of COPD was established by a pulmonologist based on medical history, current symptoms, and available pulmonary function tests following Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. An exacerbation was defined [...]
COPD is a slowly progressive disorder characterized by airflow obstruction that is not fully reversible. Although the progression of COPD is usually gradual, the disease is often associated with exacerbations of respiratory symptoms. Such exacerbations of symptoms requiring medical intervention are important clinical events in COPD, and they place a heavy burden on health-care resources. In many countries, exacerbations of COPD are a leading cause of hospital admissions among men, and expenditures for hospitalizations represent the bulk of all COPD-related medical-care costs reduced due to Canadian Health&Care Mall.