ASSESSMENT OF SEVERITY OF COPD BASED ON "BODE" INDEX

Chronic Obstructive Pulmonary Disease (COPD), the third leading cause of death in the world, causes 3.1 million deaths worldwide1 and represents an important public health challenge that is both preventable and treatable. Globally, the COPD burden is projected to increase in coming decades because of continued exposure to COPD risk factors and ageing of the population. The four factors that predicted the severity most were the body-mass index (B), the degree of airflow obstruction (O), dyspnea (D), and exercise capacity (E), measured by the six-minute-walk test. These variables were used to construct the BODE index, a multidimensional 10-point scale in which higher scores indicate a severe disease and higher risk of death. A total of 60 cases have been studied in ASRAM Medical College, Eluru, during the period between January 2013 and July 2014. A total of 20 controls were selected randomly from the patients who attended master checkup. This prospective study was conducted after the approval from the Ethical Committee of the institution. In this study 56.66% of cases are between age groups of 50 to 70. Mean age of severe disease group is 66 years (SD-11.8). This study also shows a significant decrease in BMI as BODE score increases. Smoking is a well-recognized risk factor for COPD. This study shows a significant association between smoking and BODE index. This study revealed that there was a significant increase in the BODE index in patients with a longer duration of smoking (Pack years). BODE index is a very good predictor of hospitalization. In this study there is a positive correlation between higher BODE index and longer period of hospitalization. This study also elaborates that the distance walked by patients with higher BODE scores is less when compared to other groups and controls. In this study FEV1 levels of BODE score in severe COPD group correlates well. This study concludes that BODE index is a useful tool in assessing the severity of COPD in terms of hospitalization and mortality. As the variables included in BODE index are easy, economical and can be done with ease, it is a reliable method to classify COPD patients and treat them accordingly, especially in situations with resource constraints as in developing countries like India.