BODE-Index vs HADO-Score in Chronic Obstructive Pulmonary Disease: Which one to use in general practice?

<p>Abstract</p> <p>Background</p> <p>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 (<b>B</b>ody mass index, <b>O</b>bstruction, <b>D</b>yspnea, <b>E</b>xercise capacity) and the HADO-score (<b>H</b>ealth, <b>A</b>ctivity, <b>D</b>yspnea, <b>O</b>bstruction), were compared in the prediction of mortality among COPD patients.</p> <p>Methods</p> <p>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.</p> <p>Results</p> <p>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≥ 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.</p> <p>Conclusions</p> <p>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≥ 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.</p