BODE Score may Overestimate Mortality Risk in Lung Transplantation

by Shravanthi Vikram on March 7, 2018 at 4:35 PM

Lung transplantation is essential for patients suffering with COPD. In order to qualify for a transplant, patients have to undergo an evaluation test called BODE. BODE (body mass index, obstruction, dyspnea and exercise capacity) score is a test used to predict the disease condition of a patient. It is widely used and validated for a potential lung transplant in patients. A study was conducted to determine whether the patients selected as transplant candidates had a better survival rate than the BODE score indicates. The findings of the study are published in the journal CHEST.

Researchers performed a retrospective analysis of survival according to the BODE score for 4,000 COPD patients in the United Network Organ Sharing database of lung transplant candidates. They compared survival against that observed in the cohort of COPD patients in which the BODE score was originally validated.

Chronic Obstructive Pulmonary Disease

COPD includes respiratory tract disorders that cause obstruction to airflow. These are chronic bronchitis, emphysema and small airway disease.

‘BODE score is very essential for a potential lung transplant in patients with Chronic Obstructive Pulmonary Disease (COPD).’

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They found that in models controlling for BODE score and incorporating lung transplantation as a competing end point, the risk of death was higher in the BODE validation cohort. This shows that patients selected as candidates for lung transplantation survive considerably longer than predicted by the commonly used prognostic estimates extrapolated from the BODE validation cohort. In addition, results indicated that nonrespiratory cause of death was higher in the nontransplant cohort, which supports the idea that comorbid illnesses that are screened out by the transplant selection process contribute a significant amount of morbidity.

"Survival of patients with COPD who are considered candidates for lung transplantation is significantly better than would be predicted by extrapolation of survival from the cohort in which the BODE score was validated," said Dr. Robert Reed, key researcher. "This is likely due to a lower prevalence of comorbid conditions attributable to the lung transplant evaluation screening process."

Source: Eurekalert

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