BODE-index, modified BODE-index and ADO-score in Chronic Obstructive Pulmonary Disease: Relationship with COPD phenotypes and CT lung density changes

Figures & data

Figure 1.  Distribution of multidimensional grading systems BODE, mBODE and ADO in the cohort of 72 patients with COPD.

Table 1.  Anthropometric, PFT, CT and 6MWT data, multidimensional grading indexes of 72 COPD patients (males/females 53/19)

Age (yrs)	66 (8)	MLAinsp(HU)	-874(30)
FEV1(%predicted)	56 (22)	RAI-950(%)	16(13)
FRC(%predicted)	131 (28)	MLAexp(HU)	-807(53)
DLCO(%predicted)	71 (24)	RAE-910(%)	19(15)
6MWT distance (m)	415(147)	BODE	3(2)
Borg	3.7(2.6)	mBODE	4(4)
SpO2 (%)	93(4)	ADO	4(2)

FEV₁: forced expiratory volume in 1s; FRC: functional residual capacity; DL_CO: lung diffusing capacity for carbon monoxide; 6MWT distance: distance walked at six minute walking test; Borg: dyspnea index at rest; SpO₂ (%) O₂ capillary pulse saturation; MLA_insp: mean lung attenuation at inspiration; HU: Hounsfield Unit; RAI_-950: percentage lung area with attenuation values lower than -950 HU at inspiration; MLA_exp: mean lung attenuation at expiration; RAE_-910: percentage lung area with attenuation values lower than -910 HU at expiration; BODE, mBODE, ADO: multidimensional grading systems.

Table 2.  Antropometric, PFT and CT data, 6MWT distance and multidimensional grading systems according to COPD predominant phenotype

	Predominantly Bronchial n = 44	Predominantly Emphysematous n = 28
			P
BODE	3 ± 2	4 ± 2	= 0.06
mBODE	3 ± 4	4 ± 2	= 0.07
ADO	4 ± 2	5 ± 3	= 0.30
MRC	2 ± 1	2 ± 1	= 0.28
			p
Age (yrs)	67 ± 7	64 ± 9	ns
BMI (Kg/m2)	27 ± 4	24 ± 4	<0.01
FEV1(%predicted)	62 ± 22	46 ± 18	<0.01
FRC(%predicted)	121 ± 4	147 ± 5	<0.0001
DLCO(%predicted)	77 ± 3	61 ± 5	<0.01
6MWTdistance(m)	417 ± 134	412 ± 167	ns
MLAinsp(HU)	-864 ± 4	-888 ± 7	<0.001
RAI-950(%)	12 ± 1.5	24 ± 2.7	<0.0001
MLAexp(HU)	-786 ± 8	-839 ± 5	<0.0001
RAE-910(%)	14 ± 2	26 ± 3	<0.001

Categorical variables have been compared by means of χ² test; continuous variables have been compared by means of student t-test for independent samples. BODE, mBODE, ADO: multidimensional indexes; MRC: Medical Research Council five points dyspnea scale; BMI: Body mass index; FEV₁: forced expiratory volume in 1s; FRC: functional residual capacity; DL_CO: lung diffusing capacity for carbon monoxide; 6MWT distance: distance walked at six minute walking test; MLA_insp: mean lung attenuation at inspiration; HU: Hounsfield Unit; RAI_-950: percentage lung area with attenuation values lower than -950 HU at inspiration; MLA_exp: mean lung attenuation at expiration; RAE_-910: percentage lung area with attenuation values lower than -910 HU at expiration.

Figure 2.  Point by point score value of each multidimensional grading systems (x-axis) plotted against mean densitometric values at each score point (y-axis).

Table 3.  Univariate linear regression analysis of multidimensional grading systems with inspiratory-expiratory quantitative CT lung density

	BODE		m BODE		ADO
	r	p	r	p	r	p
MLAinsp(HU)	0.24	<0.05	0.18	ns	0.12	ns
RAI-950(%)	0.58	<0.0001	0.47	<0.0001	0.34	<0.01
MLA-exp(HU)	0.57	<0.0001	0.50	<0.0001	0.43	<0.0001
RAE-910(%)	0.67	<0.0001	0.53	<0.0001	0.52	<0.0001

BODE, mBODE, ADO: multidimensional indexes; MLA_insp: mean lung attenuation at inspiration; HU: Hounsfield Unit; RAI_-950: percentage lung area with attenuation values lower than -950 HU at inspiration; MLA_exp: mean lung attenuation at expiration; RAE_-910: percentage lung area with attenuation values lower than -910 HU at expiration.

Table 4.  Multivariate regression analysis of BODE and ADO with inspiratory-expiratory quantitative lung CT densitometric parameters

Analysis	BODE	R	p	ADO	R	p
Multivariate Linear regression Direct method	Included variables			Included variables
MLAinsp(HU)	FEV1, BMI, MRC, 6MWT distance	0.43	<0.0001	Age, MRC, FEV1,	0.34	<0.0001
RAI-950(%)	FEV1, BMI, MRC, 6MWT distance	0.61	<0.0001	Age, MRC, FEV1	0.59	<0.0001
MLAexp(HU)	FEV1, BMI, MRC, 6MWT distance	0.75	<0.0001	Age, MRC, FEV1	0.72	<0.0001
RAE-910(%)	FEV1, BMI, MRC, 6MWT distance	0.73	<0.0001	Age, MRC, FEV1	0.69	<0.0001
Multivariate Linear regression Step-wise analysis	Included variables			Included variables
MLAinsp(HU)	FEV1, BMI	0.41	<0.0001	FEV1	0.33	<0.0001
RAI-950(%)	FEV1, BMI, MRC	0.61	<0.0001	FEV1, MRC	0.57	<0.0001
MLAexp(HU)	FEV1, BMI	0.75	<0.0001	FEV1	0.71	<0.0001
RAE-910(%)	FEV1, BMI, MRC	0.72	<0.0001	FEV1, MRC	0.68	<0.0001

BODE, ADO: multidimensional indexes; MLA_insp: mean lung attenuation at inspiration; HU: Hounsfield Unit; RAI_-950: percentage lung area with attenuation values lower than -950 HU at inspiration; MLA_exp: mean lung attenuation at expiration; RAE_-910: percentage lung area with attenuation values lower than -910 HU at expiration; FEV₁: forced expiratory volume in 1s; BMI: Body mass index; MRC: Medical Research Council five points dyspnea scale; 6MWT distance: distance walked at 6-minute walking test.

Agusti A, Calverley PM, Celli B, Characterisation of COPD heterogeneity in the ECLIPSE cohort. Respir Res 2010; 11:122.

 PubMed Web of Science ®Google Scholar

Kalender WA, Fichte H, Bautz W, Semiautomatic evaluation procedures for quantitative CT of the lung. J Comput Assist Tomogr 1991; 15:248–55.

 PubMed Web of Science ®Google Scholar