Almagro et al reported the CODEX index for patients with chronic obstructive pulmonary disease (COPD). This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in Spain.
Patient selection: COPD
Parameters:
(1) Charlson comorbidity index (C)
(2) obstruction (O) based on FEV1 as percent of predicted
(3) dyspnea (D) based on the modified MRC dyspnea scale
(4) exacerbation (EX)
Parameter
Finding
Points
Charlson comorbidity index
0 to 4
0
5 to 7
1
>= 8
2
FEV1
>= 65%
0
50 to 64%
1
36 to 49%
2
<= 35%
3
modified MRC dyspnea
0 or 1
0
2
1
3
2
4
3
exacerbations
0
0
1 or 2
1
>= 3
2
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• A score >= 5 is associated with a worse 3-month (8%) and 1-year mortality rate (20%).
Performance:
• The area under the ROC curve for 1-year mortality is 0.68.
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