Adrenomedullin refines mortality prediction by the BODE index in COPD: the "BODE-A" index

Stolz, Daiana and Kostikas, Kostantinos and Blasi, Francesco and Boersma, Wim and Milenkovic, Branislava and Lacoma, Alicia and Louis, Renaud and Aerts, Joachim G. and Welte, Tobias and Torres, Antoni and Rohde, Gernot G. U. and Boeck, Lucas and Rakic, Janko and Scherr, Andreas and Hertel, Sabine and Giersdorf, Sven and Tamm, Michael. (2014) Adrenomedullin refines mortality prediction by the BODE index in COPD: the "BODE-A" index. European Respiratory Journal, 43 (2). pp. 397-408.

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The BODE (body mass index, airflow obstruction, dyspnoea, exercise capacity) index is well-validated for mortality prediction in chronic obstructive pulmonary disease (COPD). Concentrations of plasma pro-adrenomedullin, a surrogate for mature adrenomedullin, independently predicted 2-year mortality among inpatients with COPD exacerbation. We compared accuracy of initial pro-adrenomedullin level, BODE and BODE components, alone or combined, in predicting 1-year or 2-year all-cause mortality in a multicentre, multinational observational cohort with stable, moderate to very severe COPD. Pro-adrenomedullin was significantly associated (p<0.001) with 1-year mortality (4.7%) and 2-year mortality (7.8%) and comparably predictive to BODE regarding both (C statistics 0.691 versus 0.745 and 0.635 versus 0.679, respectively). Relative to using BODE alone, adding pro-adrenomedullin significantly improved 1-year and 2-year mortality prognostication (C statistics 0.750 and 0.818, respectively; both p<0.001). Pro-adrenomedullin plus BOD was more predictive than the original BODE including 6-min walk distance. In multivariable analysis, pro-adrenomedullin (likelihood ratio Chi-squared 13.0, p<0.001), body mass index (8.5, p=0.004) and 6-min walk distance (7.5, p=0.006) independently foretold 2-year survival, but modified Medical Research Council dyspnoea score (2.2, p=0.14) and forced expiratory volume in 1 s % predicted (0.3, p=0.60) did not. Pro-adrenomedullin plus BODE better predicts mortality in COPD patients than does BODE alone; pro-adrenomedullin may substitute for 6-min walk distance in BODE when 6-min walk testing is unavailable.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Pneumologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Pneumologie
UniBasel Contributors:Boeck, Lucas
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:European Respiratory Society
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:05 Oct 2017 10:12
Deposited On:05 Oct 2017 10:12

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