A simplified score to quantify comorbidity in COPD. Academic Article uri icon

Overview

MeSH

  • Area Under Curve
  • Humans
  • Quality of Life
  • Surveys and Questionnaires

MeSH Major

  • Comorbidity
  • Cost of Illness
  • Health Status Indicators
  • Patient Outcome Assessment
  • Pulmonary Disease, Chronic Obstructive

abstract

  • Comorbidities are common in COPD, but quantifying their burden is difficult. Currently there is a COPD-specific comorbidity index to predict mortality and another to predict general quality of life. We sought to develop and validate a COPD-specific comorbidity score that reflects comorbidity burden on patient-centered outcomes. Using the COPDGene study (GOLD II-IV COPD), we developed comorbidity scores to describe patient-centered outcomes employing three techniques: 1) simple count, 2) weighted score, and 3) weighted score based upon statistical selection procedure. We tested associations, area under the Curve (AUC) and calibration statistics to validate scores internally with outcomes of respiratory disease-specific quality of life (St. George's Respiratory Questionnaire, SGRQ), six minute walk distance (6MWD), modified Medical Research Council (mMRC) dyspnea score and exacerbation risk, ultimately choosing one score for external validation in SPIROMICS. Associations between comorbidities and all outcomes were comparable across the three scores. All scores added predictive ability to models including age, gender, race, current smoking status, pack-years smoked and FEV1 (p<0.001 for all comparisons). Area under the curve (AUC) was similar between all three scores across outcomes: SGRQ (range 0·7624-0·7676), MMRC (0·7590-0·7644), 6MWD (0·7531-0·7560) and exacerbation risk (0·6831-0·6919). Because of similar performance, the comorbidity count was used for external validation. In the SPIROMICS cohort, the comorbidity count performed well to predict SGRQ (AUC 0·7891), MMRC (AUC 0·7611), 6MWD (AUC 0·7086), and exacerbation risk (AUC 0·7341). Quantifying comorbidity provides a more thorough understanding of the risk for patient-centered outcomes in COPD. A comorbidity count performs well to quantify comorbidity in a diverse population with COPD.

publication date

  • 2014

has subject area

  • Area Under Curve
  • Comorbidity
  • Cost of Illness
  • Health Status Indicators
  • Humans
  • Patient Outcome Assessment
  • Pulmonary Disease, Chronic Obstructive
  • Quality of Life
  • Surveys and Questionnaires

Research

keywords

  • Journal Article

Identity

Language

  • eng

PubMed Central ID

  • PMC4267736

Digital Object Identifier (DOI)

  • 10.1371/journal.pone.0114438

PubMed ID

  • 25514500

Additional Document Info

start page

  • e114438

volume

  • 9

number

  • 12