Abstract
Introduction
Little is known about survival and prognostic factors in chronic obstructive pulmonary disease (COPD) due to biomass smoke exposure (BS-COPD).
Objectives
(1) To determine the value of two indices of COPD severity: BODEx (body mass index, obstruction, dyspnea, and previous severe exacerbations) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) categories system (ABCD) to predict all-cause mortality in BS-COPD, compared with COPD due to tobacco (T-COPD); (2) to verify the usefulness of 2 comorbidity indices, Charlson index and COTE (COPD comorbidity index); and (3) to put side by side the value of these indices.
Methods
612 consecutive COPD patients were retrospectively studied. Prognostic factors were evaluated taking into account the exposure to biomass or tobacco smoke. The relative predictive values of the prognostic indices were compared using receiver-operating characteristic analysis.
Results
Mortality in the BS-COPD and T-COPD groups was not significantly different, when sex was taken into account. BODEx, Charlson and COTE indices—but not type of exposure—predicted mortality in multivariate analysis. The value of the C-statistic for the BODEx index was not different than that of GOLD ABCD for BS-COPD, but was higher for T-COPD. The discriminatory value of the Charlson index was higher than that of COTE for BS-COPD, but no significant differences were found for T-COPD.
Conclusions
Multidimensional indices of COPD severity and comorbidity predict all-cause mortality in BS-COPD. The behavior of the different indices is different for BS-COPD and T-COPD.
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References
Global Strategy for the Diagnosis, Management and Prevention of COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2014. http://www.goldcopd.org/
Celli BR, Cote CG, Marín JM, Casanova C, Montes de Oca M, Mendez RA et al (2004) The body-mass index, airflow obstruction, dyspnea and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 350:1005–1012
Miravitlles M, Soler-Cataluña JJ, Calle M, Molina J, Almagro P, Quintano JA et al (2012) Spanish COPD guidelines (GesEPOC): pharmacological treatment of stable COPD. Spanish Society of Pulmonology and Thoracic Surgery. Arch Bronconeumol 48:247–257
Soler-Cataluña JJ, Martínez-García MA, SánchezSánchez L, PerpiñáTordera M, RománSánchez P (2009) Severe exacerbations and BODE index: two independent risk factors for death in male COPD patients. Resp Med 103:692–699
Charlson ME, Pompei P, Ales K, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–438
Divo M, Cote C, de Torres JP, Casanova C, Marín JM, Pinto-Plata V et al (2012) Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 186:155–161
Salvi SS, Barnes PJ (2009) Chronic obstructive pulmonary disease in non-smokers. Lancet 374:733–743
De Torres JP, Cote CG, López MV, Casanova C, Diaz O, Marín JM et al (2009) Sex differences in mortality in patients with COPD. Eur Respir J 33:528–535
DeLong ER, DeLong DM, Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44:837–845
Orozco-Levi M, García-Aymerich J, Villar J, Ramírez-Sarmiento A, Antó JM, Gea J (2006) Wood smoke exposure and risk of chronic obstructive pulmonary disease. Eur Respir J 27:542–546
Golpe R, Sanjuán-López P, Cano-Jiménez E, Castro-Añón O, Pérez-de-Llano LA (2014) Distribution of clinical phenotypes in patients with chronic obstructive pulmonary disease caused by biomass and tobacco smoke. Arch Bronconeumol 50:318–324
Camp PG, Ramírez-Venegas A, Sansores RH, Alva LF, McDougall JE, Sin DD et al (2014) COPD phenotypes in biomass smoke-versus tobacco smoke-exposed Mexican women. Eur Respir J 43:725–734
Rivera RM, Cosio MG, Ghezzo H, Salazar M, Pérez-Padilla R (2008) Comparison of lung morphology in COPD secondary to cigarette and biomass smoke. Int J Tuberc Lung Dis 12:972–977
Ramírez-Venegas A, Sansores RH, Quintana-Carrillo RH, Velázquez-Uncal M, Hernández-Zenteno RJ, Sánchez-Romero C et al (2014) FEV1 decline in patients with chronic obstructive pulmonary disease associated with biomass exposure. Am J Respir Crit Care Med 190:996–1002
Ramírez-Venegas A, Sansores RH, Pérez-Padilla R, Regalado J, Velázquez A, Sánchez C et al (2006) Survival of patients with chronic obstructive pulmonary disease due to biomass smoke and tobacco. Am J Respir Crit Care Med 173:393–397
Dijk WD, Lv Bemt, Sv Haak-Rongen, Bischoff E, Cv Weel, Veen JC et al (2011) Multidimensional prognostic indices for use in COPD patient care. A systematic review. Respir Res 12:151
Soriano JB, Alfageme I, Almagro P et al (2013) Distribution and prognostic validity of the new global initiative for chronic obstructive lung disease grading classification. Chest 143:694–702
De Torres JP, Casanova C, Marin JM, Pinto-Plata V, Divo M, Zulueta JJ et al (2014) Prognostic evaluation of COPD patients: GOLD 2011 versus BODE and the COPD comorbidity index COTE. Thorax 69:799–804
Soriano JB, Visick GT, Muellerova H, Payvandi N, Hansell AL (2005) Patterns of comorbidities in newly diagnosed COPD and asthma in primary care. Chest 128:2099–2107
Terzano C, Conti V, Di Stefano F, Petroianni A, Ceccarelli D, Graziani E et al (2010) Comorbidity, hospitalization, and mortality in COPD: results from a longitudinal study. Lung 188:321–329
Almagro P, Cabrera FJ, Diez J, Boixeda R, Alonso Ortiz MB, Murio C et al (2012) Comorbidities and short-term prognosis in patients hospitalized for acute exacerbations of COPD: the EPOC en servicios de medicina interna (ESMI) study. Chest 142:1126–1133
Compliance with Ethical Standards
The study was approved by our local ethical committee (Registry number: CAEI Galicia 2014/016) and was performed in accordance with the 1964 Declaration of Helsinki and its later amendments.
Conflict of interest
The authors declare that they not have conflicts of interest, financial or otherwise, regarding the manuscript.
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Golpe, R., Mengual-Macenlle, N., Sanjuán-López, P. et al. Prognostic Indices and Mortality Prediction in COPD Caused by Biomass Smoke Exposure. Lung 193, 497–503 (2015). https://doi.org/10.1007/s00408-015-9731-9
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DOI: https://doi.org/10.1007/s00408-015-9731-9