Short- and medium-term prognosis in patients hospitalized for COPD exacerbation: The CODEX index.

Link to article at PubMed

Short- and medium-term prognosis in patients hospitalized for COPD exacerbation: The CODEX index.

Chest. 2013 Sep 26;

Authors: Almagro P, Soriano J, Cabrera F, Boixeda R, Alonso M, Barreiro B, Diez-Manglano J, Murio C, Heredia J, Working Group on COPD, Spanish Society of Internal Medicine.*

BACKGROUND: No valid tools exist for evaluating prognosis in the short- and medium-term after hospital discharge of COPD patients. Our hypothesis was that a new index based on Comorbidity, Obstruction, Dyspnea, and previous severe EXacerbations (CODEX index) can predict accurately mortality, hospital readmission, and their combination for the period from three months to one year after discharge in patients hospitalized for COPD.
METHODS: A multicenter study of patients hospitalized for a COPD exacerbation was used to develop the CODEX index, and a different patient cohort was used for validation. Comorbidity was measured using the age-adjusted Charlson index, whilst dyspnea, obstruction and severe exacerbations were calculated according to BODEX thresholds. Information about mortality and readmissions for COPD or other causes was collected at 3 and 12 months after hospital discharge.
RESULTS: Two sets of 606 and 377 patients were included in the development and validation cohorts, respectively. The CODEX index was associated with mortality at 3 months (p <0.0001, HR 1.5, 95% CI 1.2-1.8) and one year (p<0.0001; H.R. 1.3; O.R. 95%: 1.2-1.5), hospital readmissions in the same periods and their combination (all p<0.0001). All CODEX C statistics were superior to the BODEX, DOSE, and updated ADO.
CONCLUSIONS: The CODEX index was a useful predictor of survival and readmission both at 3 months and one year after hospital discharge for a COPD exacerbation, with a prognostic capacity superior to other previously published indices.

PMID: 24077342 [PubMed - as supplied by publisher]

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