Comparison of Global Initiative for Chronic Obstructive Pulmonary Disease 2013 classification and body mass index, airflow obstruction, dyspnea, and exacerbations index in predicting mortality and exacerbations in elderly adults with chronic obstructive pulmonary disease

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Abstract

Objectives To examine whether the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) 2013 revision offers greater predictive ability than the body mass index, airflow obstruction, dyspnea, and exacerbations (BODEx) index in elderly adults with chronic obstructive pulmonary disease (COPD). Design Prospective cohort study. Setting University-affiliated medical center. Participants Taiwanese outpatients with COPD (N = 354). Measurements Participants were classified as Group A (low risk with mild dyspnea), Group B (low risk with more-severe dyspnea), Group C (high risk with mild dyspnea), and Group D (high risk with more-severe dyspnea) for GOLD 2013 and from Quartile 1 (0-2 points) to 4 (7-9 points) for BODEx score. Ability to predict exacerbations and mortality was compared using logistic regression analysis with receiver operating characteristic (ROC) curve estimations and area under the ROC curve (AUC). Results Mortality was 14.1% for GOLD Group A, 14.5% for Group B, 6.5% for Group C, and 35.8% for Group D and 15.2% for BODEx Quartile 1, 22.5% for Quartile 2, 28.1% for Quartile 3, and 79.2% for Quartile 4. Risk of exacerbation relative to Group A was 1.7 (95% confidence interval (CI) = 0.6-4.3) for Group B, 14.1 (95% CI = 4.6-43.2) for Group C, and 17.9 (95% CI = 7.6-42.0) for Group D. The AUC for the GOLD classification and BODEx index were 0.65 and 0.67 for mortality (P =.60) and 0.79 and 0.73 for exacerbation (P =.03). Conclusion The GOLD 2013 classification performed well in identifying individuals at risk of exacerbations, and its predictive ability for exacerbations was better than that of the BODEx index, although the predictive ability for mortality in elderly adults with COPD was poor for both indices.

Original languageEnglish
Pages (from-to)244-250
Number of pages7
JournalJournal of the American Geriatrics Society
Volume63
Issue number2
DOIs
Publication statusPublished - 2015 Feb 1

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Dyspnea
Chronic Obstructive Pulmonary Disease
Body Mass Index
Mortality
ROC Curve
Confidence Intervals
Area Under Curve
Cohort Studies
Outpatients
Logistic Models
Regression Analysis
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Geriatrics and Gerontology

Cite this

@article{e4cf696d57074ccbaf8e20a5fc78e0e7,
title = "Comparison of Global Initiative for Chronic Obstructive Pulmonary Disease 2013 classification and body mass index, airflow obstruction, dyspnea, and exacerbations index in predicting mortality and exacerbations in elderly adults with chronic obstructive pulmonary disease",
abstract = "Objectives To examine whether the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) 2013 revision offers greater predictive ability than the body mass index, airflow obstruction, dyspnea, and exacerbations (BODEx) index in elderly adults with chronic obstructive pulmonary disease (COPD). Design Prospective cohort study. Setting University-affiliated medical center. Participants Taiwanese outpatients with COPD (N = 354). Measurements Participants were classified as Group A (low risk with mild dyspnea), Group B (low risk with more-severe dyspnea), Group C (high risk with mild dyspnea), and Group D (high risk with more-severe dyspnea) for GOLD 2013 and from Quartile 1 (0-2 points) to 4 (7-9 points) for BODEx score. Ability to predict exacerbations and mortality was compared using logistic regression analysis with receiver operating characteristic (ROC) curve estimations and area under the ROC curve (AUC). Results Mortality was 14.1{\%} for GOLD Group A, 14.5{\%} for Group B, 6.5{\%} for Group C, and 35.8{\%} for Group D and 15.2{\%} for BODEx Quartile 1, 22.5{\%} for Quartile 2, 28.1{\%} for Quartile 3, and 79.2{\%} for Quartile 4. Risk of exacerbation relative to Group A was 1.7 (95{\%} confidence interval (CI) = 0.6-4.3) for Group B, 14.1 (95{\%} CI = 4.6-43.2) for Group C, and 17.9 (95{\%} CI = 7.6-42.0) for Group D. The AUC for the GOLD classification and BODEx index were 0.65 and 0.67 for mortality (P =.60) and 0.79 and 0.73 for exacerbation (P =.03). Conclusion The GOLD 2013 classification performed well in identifying individuals at risk of exacerbations, and its predictive ability for exacerbations was better than that of the BODEx index, although the predictive ability for mortality in elderly adults with COPD was poor for both indices.",
author = "Chiung-Zuei Chen and Chih-Ying Ou and Chun-Hsiang Yu and Seu-Chun Yang and Han-Yu Chang and Tzuen-Ren Hsiue",
year = "2015",
month = "2",
day = "1",
doi = "10.1111/jgs.13258",
language = "English",
volume = "63",
pages = "244--250",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "2",

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TY - JOUR

T1 - Comparison of Global Initiative for Chronic Obstructive Pulmonary Disease 2013 classification and body mass index, airflow obstruction, dyspnea, and exacerbations index in predicting mortality and exacerbations in elderly adults with chronic obstructive pulmonary disease

AU - Chen, Chiung-Zuei

AU - Ou, Chih-Ying

AU - Yu, Chun-Hsiang

AU - Yang, Seu-Chun

AU - Chang, Han-Yu

AU - Hsiue, Tzuen-Ren

PY - 2015/2/1

Y1 - 2015/2/1

N2 - Objectives To examine whether the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) 2013 revision offers greater predictive ability than the body mass index, airflow obstruction, dyspnea, and exacerbations (BODEx) index in elderly adults with chronic obstructive pulmonary disease (COPD). Design Prospective cohort study. Setting University-affiliated medical center. Participants Taiwanese outpatients with COPD (N = 354). Measurements Participants were classified as Group A (low risk with mild dyspnea), Group B (low risk with more-severe dyspnea), Group C (high risk with mild dyspnea), and Group D (high risk with more-severe dyspnea) for GOLD 2013 and from Quartile 1 (0-2 points) to 4 (7-9 points) for BODEx score. Ability to predict exacerbations and mortality was compared using logistic regression analysis with receiver operating characteristic (ROC) curve estimations and area under the ROC curve (AUC). Results Mortality was 14.1% for GOLD Group A, 14.5% for Group B, 6.5% for Group C, and 35.8% for Group D and 15.2% for BODEx Quartile 1, 22.5% for Quartile 2, 28.1% for Quartile 3, and 79.2% for Quartile 4. Risk of exacerbation relative to Group A was 1.7 (95% confidence interval (CI) = 0.6-4.3) for Group B, 14.1 (95% CI = 4.6-43.2) for Group C, and 17.9 (95% CI = 7.6-42.0) for Group D. The AUC for the GOLD classification and BODEx index were 0.65 and 0.67 for mortality (P =.60) and 0.79 and 0.73 for exacerbation (P =.03). Conclusion The GOLD 2013 classification performed well in identifying individuals at risk of exacerbations, and its predictive ability for exacerbations was better than that of the BODEx index, although the predictive ability for mortality in elderly adults with COPD was poor for both indices.

AB - Objectives To examine whether the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) 2013 revision offers greater predictive ability than the body mass index, airflow obstruction, dyspnea, and exacerbations (BODEx) index in elderly adults with chronic obstructive pulmonary disease (COPD). Design Prospective cohort study. Setting University-affiliated medical center. Participants Taiwanese outpatients with COPD (N = 354). Measurements Participants were classified as Group A (low risk with mild dyspnea), Group B (low risk with more-severe dyspnea), Group C (high risk with mild dyspnea), and Group D (high risk with more-severe dyspnea) for GOLD 2013 and from Quartile 1 (0-2 points) to 4 (7-9 points) for BODEx score. Ability to predict exacerbations and mortality was compared using logistic regression analysis with receiver operating characteristic (ROC) curve estimations and area under the ROC curve (AUC). Results Mortality was 14.1% for GOLD Group A, 14.5% for Group B, 6.5% for Group C, and 35.8% for Group D and 15.2% for BODEx Quartile 1, 22.5% for Quartile 2, 28.1% for Quartile 3, and 79.2% for Quartile 4. Risk of exacerbation relative to Group A was 1.7 (95% confidence interval (CI) = 0.6-4.3) for Group B, 14.1 (95% CI = 4.6-43.2) for Group C, and 17.9 (95% CI = 7.6-42.0) for Group D. The AUC for the GOLD classification and BODEx index were 0.65 and 0.67 for mortality (P =.60) and 0.79 and 0.73 for exacerbation (P =.03). Conclusion The GOLD 2013 classification performed well in identifying individuals at risk of exacerbations, and its predictive ability for exacerbations was better than that of the BODEx index, although the predictive ability for mortality in elderly adults with COPD was poor for both indices.

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DO - 10.1111/jgs.13258

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