Table of ContentsView AllTable of ContentsFactors Affecting PrognosisBODE Index ResultsCOPD and Lung Cancer Risk
Table of ContentsView All
View All
Table of Contents
Factors Affecting Prognosis
BODE Index Results
COPD and Lung Cancer Risk
While certainly a difficult topic to consider if you or a loved one have beendiagnosed with the disease, learning the prognosis of COPD can be important. For some, it is what prompts them to make much-needed changes that may improve their quality of life and help them live longer.
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While there are no hard-and-fast rules that govern how long a person can live with COPD, a system called theBODE indexhas been developed to help with predictions.
The BODE index considers four different measures—body mass index (BMI), airway obstruction, dyspnea, and exercise tolerance—each of which is given a certain number of points. While individually informative, added together, these scores make a more accurate prediction about how long someone will live after a diagnosis of COPD.
Note, however, that the BODE index provides only a general prediction of mortality. There are many other factors that can affect mortality in people with COPD, and this test is not perfect.
It is now known that age may also play a role in the BODE index’s accuracy.
B—Body Mass Index
Keep in mind, however, that BMI is a dated, flawed measure. It does not take into account factors such as body composition, ethnicity, sex, race, and age. Even though it is a biased measure, BMI is still widely used in the medical community because it’s an inexpensive and quick way to analyze a person’s potential health status and outcomes.
1
Researchers Say Waist-to-Hip Ratio Should Replace BMI—Here’s Why
O—Obstruction (of the Airway)
Normally, this percentage is greater than 65%, which means the majority of air is exhaled in the first second of breathing out. If there is an obstruction in the airways that slows or prevents this rapid exhalation of air, the percentage decreases.
FEV1 is a strong predictor of survival in people with COPD. Those with severe airway obstruction on long-term oxygen therapy have low survival rates (roughly 70% to year one, 50% to year two, and 43% to year three).
D—Dyspnea
Dyspneais the physical sensation of shortness of breath or breathlessness. Healthcare providers make distinctions based on what someone may need to do—how active they are—before they become short of breath. Early on, a person with COPD may only become breathless if they walk 5 miles. Later on, that same person may note breathlessness with any movement at all.
Dyspnea evaluation rates a person’s perception of their COPD symptoms and translates those perceptions into measurable value. While FEV1 has been regarded as the best way to predict COPD mortality, the dyspnea level may be more significant when predicting survival.
E—Exercise Tolerance
A standard test called thesix-minute walk testis used to obtain the exercise capacity value for the BODE index. It can provide both an estimate of hospitalizations and risk of death. Unintended stops during the test and other measured variables appear to be good prognostic factors in COPD.
After the appropriate points for the factors above have been determined, they are added together. The BODE index is graded on a scale of 0 to 10, with lower grades (final scores) corresponding to longer survival times and higher grades corresponding to shorter survival times:
Total BODE Index PointsLikelihood of Surviving for Four Years0 to 280%3 to 467%5 to 657%7 to 1018%In considering each of the individual values that go into the total BODE index score, your healthcare provider can offer ways to improve upon your grading.ConsiderationsTests like this are good for making general predictions and evaluating statistics, but they do not necessarily give predictive information for individual people. Someone with a very high score could end up living for decades, and the opposite could be true for someone with a low score.The BODE index is meant to be used as a tool for informational purposes only. It should not replace the advice of a healthcare professional.COPD and Lung Cancer RiskAnother major factor contributing to the life expectancy of someone with COPD is lung cancer risk. COPD is considered an independent risk factor for lung cancer, meaning that just having COPD greatly increases your chances of contracting cancer, regardless of whether you ever smoked cigarettes.Nonsmokers with COPD are more likely to develop lung cancer than nonsmokers without COPD, and smokers with COPD are more likely to develop lung cancer than those who smoke and don’t have COPD.If you have COPD, talk to a healthcare provider about alung cancer screening, and familiarize yourself with the symptoms of the condition.Signs and Symptoms of Lung CancerSummaryPredicting life expectancy with COPD is not an exact science. The BODE index uses four measures to give a fairly accurate prognosis for someone with COPD, but it’s not always right.Talk to a healthcare provider about lung cancer screening, and remember that the BODE index doesn’tdictatehow long you have to live. Rather, it informs you in order to determine the steps you can take toimprove your condition. Chief among these is smoking. No other changeable factor has a greater impact on your survival time than the habit of lighting up.The Differences Between COPD and Asthma
In considering each of the individual values that go into the total BODE index score, your healthcare provider can offer ways to improve upon your grading.
Considerations
Tests like this are good for making general predictions and evaluating statistics, but they do not necessarily give predictive information for individual people. Someone with a very high score could end up living for decades, and the opposite could be true for someone with a low score.
The BODE index is meant to be used as a tool for informational purposes only. It should not replace the advice of a healthcare professional.
Another major factor contributing to the life expectancy of someone with COPD is lung cancer risk. COPD is considered an independent risk factor for lung cancer, meaning that just having COPD greatly increases your chances of contracting cancer, regardless of whether you ever smoked cigarettes.
Nonsmokers with COPD are more likely to develop lung cancer than nonsmokers without COPD, and smokers with COPD are more likely to develop lung cancer than those who smoke and don’t have COPD.
If you have COPD, talk to a healthcare provider about alung cancer screening, and familiarize yourself with the symptoms of the condition.
Signs and Symptoms of Lung Cancer
Summary
Predicting life expectancy with COPD is not an exact science. The BODE index uses four measures to give a fairly accurate prognosis for someone with COPD, but it’s not always right.
Talk to a healthcare provider about lung cancer screening, and remember that the BODE index doesn’tdictatehow long you have to live. Rather, it informs you in order to determine the steps you can take toimprove your condition. Chief among these is smoking. No other changeable factor has a greater impact on your survival time than the habit of lighting up.
The Differences Between COPD and Asthma
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Marchand E, Jamart J, Pirard L.Age but not smoking status significantly adds to the Bode index for the prediction of survival in COPD patients.Am J Respir Crit Care Med. 2017;195:A2711Guo Y, Zhang T, Wang Y, et al.Body mass index and mortality in chronic obstructive pulmonary disease: A dose–response meta-analysis.Medicine (Baltimore). 2016;95(28):e4225. doi:10.1097/MD.0000000000004225Gutin I.In BMI We Trust: Reframing the Body Mass Index as a Measure of Health.Soc Theory Health. 2018;16(3):256-271. doi:10.1057/s41285-017-0055-0Bailey KL.The importance of the assessment of pulmonary function in COPD.Med Clin North Am. 2012;96(4):745–752. doi:10.1016/j.mcna.2012.04.011Rajala K, Lehto JT, Sutinen E, Kautiainen H, Myllärniemi M, Saarto T.mMRC dyspnoea scale indicates impaired quality of life and increased pain in patients with idiopathic pulmonary fibrosis.ERJ Open Res. 2017;3(4):00084-2017. doi:10.1183/23120541.00084-2017Andrianopoulos V, Wouters EFM, Pinto-Plata VM, et al.Prognostic value of variables derived from the six-minute walk test in patients with COPD: Results from the ECLIPSE study.Respir Med. 2015;109(9):1138-1146. doi:10.1016/j.rmed.2015.06.013MDCalc.BODE Index for COPD Survival.Durham AL, Adcock IM.The relationship between COPD and lung cancer.Lung Cancer. 2015;90(2):121–127. doi:10.1016/j.lungcan.2015.08.017
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Marchand E, Jamart J, Pirard L.Age but not smoking status significantly adds to the Bode index for the prediction of survival in COPD patients.Am J Respir Crit Care Med. 2017;195:A2711Guo Y, Zhang T, Wang Y, et al.Body mass index and mortality in chronic obstructive pulmonary disease: A dose–response meta-analysis.Medicine (Baltimore). 2016;95(28):e4225. doi:10.1097/MD.0000000000004225Gutin I.In BMI We Trust: Reframing the Body Mass Index as a Measure of Health.Soc Theory Health. 2018;16(3):256-271. doi:10.1057/s41285-017-0055-0Bailey KL.The importance of the assessment of pulmonary function in COPD.Med Clin North Am. 2012;96(4):745–752. doi:10.1016/j.mcna.2012.04.011Rajala K, Lehto JT, Sutinen E, Kautiainen H, Myllärniemi M, Saarto T.mMRC dyspnoea scale indicates impaired quality of life and increased pain in patients with idiopathic pulmonary fibrosis.ERJ Open Res. 2017;3(4):00084-2017. doi:10.1183/23120541.00084-2017Andrianopoulos V, Wouters EFM, Pinto-Plata VM, et al.Prognostic value of variables derived from the six-minute walk test in patients with COPD: Results from the ECLIPSE study.Respir Med. 2015;109(9):1138-1146. doi:10.1016/j.rmed.2015.06.013MDCalc.BODE Index for COPD Survival.Durham AL, Adcock IM.The relationship between COPD and lung cancer.Lung Cancer. 2015;90(2):121–127. doi:10.1016/j.lungcan.2015.08.017
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Marchand E, Jamart J, Pirard L.Age but not smoking status significantly adds to the Bode index for the prediction of survival in COPD patients.Am J Respir Crit Care Med. 2017;195:A2711Guo Y, Zhang T, Wang Y, et al.Body mass index and mortality in chronic obstructive pulmonary disease: A dose–response meta-analysis.Medicine (Baltimore). 2016;95(28):e4225. doi:10.1097/MD.0000000000004225Gutin I.In BMI We Trust: Reframing the Body Mass Index as a Measure of Health.Soc Theory Health. 2018;16(3):256-271. doi:10.1057/s41285-017-0055-0Bailey KL.The importance of the assessment of pulmonary function in COPD.Med Clin North Am. 2012;96(4):745–752. doi:10.1016/j.mcna.2012.04.011Rajala K, Lehto JT, Sutinen E, Kautiainen H, Myllärniemi M, Saarto T.mMRC dyspnoea scale indicates impaired quality of life and increased pain in patients with idiopathic pulmonary fibrosis.ERJ Open Res. 2017;3(4):00084-2017. doi:10.1183/23120541.00084-2017Andrianopoulos V, Wouters EFM, Pinto-Plata VM, et al.Prognostic value of variables derived from the six-minute walk test in patients with COPD: Results from the ECLIPSE study.Respir Med. 2015;109(9):1138-1146. doi:10.1016/j.rmed.2015.06.013MDCalc.BODE Index for COPD Survival.Durham AL, Adcock IM.The relationship between COPD and lung cancer.Lung Cancer. 2015;90(2):121–127. doi:10.1016/j.lungcan.2015.08.017
Marchand E, Jamart J, Pirard L.Age but not smoking status significantly adds to the Bode index for the prediction of survival in COPD patients.Am J Respir Crit Care Med. 2017;195:A2711
Guo Y, Zhang T, Wang Y, et al.Body mass index and mortality in chronic obstructive pulmonary disease: A dose–response meta-analysis.Medicine (Baltimore). 2016;95(28):e4225. doi:10.1097/MD.0000000000004225
Gutin I.In BMI We Trust: Reframing the Body Mass Index as a Measure of Health.Soc Theory Health. 2018;16(3):256-271. doi:10.1057/s41285-017-0055-0
Bailey KL.The importance of the assessment of pulmonary function in COPD.Med Clin North Am. 2012;96(4):745–752. doi:10.1016/j.mcna.2012.04.011
Rajala K, Lehto JT, Sutinen E, Kautiainen H, Myllärniemi M, Saarto T.mMRC dyspnoea scale indicates impaired quality of life and increased pain in patients with idiopathic pulmonary fibrosis.ERJ Open Res. 2017;3(4):00084-2017. doi:10.1183/23120541.00084-2017
Andrianopoulos V, Wouters EFM, Pinto-Plata VM, et al.Prognostic value of variables derived from the six-minute walk test in patients with COPD: Results from the ECLIPSE study.Respir Med. 2015;109(9):1138-1146. doi:10.1016/j.rmed.2015.06.013
MDCalc.BODE Index for COPD Survival.
Durham AL, Adcock IM.The relationship between COPD and lung cancer.Lung Cancer. 2015;90(2):121–127. doi:10.1016/j.lungcan.2015.08.017
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