Comparison between Spirometry and BODE Index for Clinical Assessment in Chronic Obstructive Pulmonary Disease Patients

Classification of severity of airflow limitation in Chronic Obstructive Pulmonary Disease (COPD) does not represent the clinical consequences of COPD. Hence, combined COPD assessment should be preferred. The BODE index has recently been proposed to provide useful prognostic information. The present study aimed to identify the best component in the assessment of severity in terms of BODE index and spirometry. A prospective comparative study was carried out with 70 COPD patients recruited over 10 months at the Pulmonary Medicine outpatient department of a tertiary care hospital in Tamilnadu, India. Patients were classified according to the GOLD classification of severity of airflow limitation after performing spirometry. The BMI, dyspnea, 6 min walking distance, FEV1 and BODE index was calculated for each patient. Patients were started on inhalation therapy and pulmonary rehabilitation and followed-up every fortnightly, after 2 months of the treatment, to repeat the BODE index and spirometry. Comparison was done between the FEV1 and BODE index before and after treatment. The mean FEV1 before the treatment was 51.00 (15.21) and after the treatment, it was 48.75 (14.92). There is no statistical difference found between pre and post treatment. However, the mean BODE index score before treatment was 5.47 (1.95) and after the treatment was 4.70 (2.35). With 95% confidence interval, the level of significance was 0.001. The present study concluded that, for the assessment of severity in COPD patients, BODE index helps in a better manner than FEV1 in response to medical intervention. Calculating BODE index is simple and needs no special equipment. This makes it a potential tool of potentially widespread applicability.