Patient selection: stable COPD
Parameters:
(1) general health (H), based on bad, fair, good, very good or excellent
(2) physical activity (A)
(3) level of dyspnea (D)
(4) FEV1 (O), based on FEV1 as percent of predicted
(5) hospitalization (H) for COPD exacerbation in past 2 years
(6) age (A)
|
Parameter
|
Finding
|
Points
|
|
general health
|
bad
|
1
|
|
|
other
|
0
|
|
physical activity
|
high (can walk > 4 hours per week)
|
0
|
|
|
medium (can walk 2-4 hours per week)
|
3
|
|
|
low (can walk < 2 hours per week)
|
3
|
|
|
very low (restricted to home, can walk less than 100 meters)
|
4
|
|
level of dyspnea
|
1 (with intense exercise)
|
0
|
|
|
2 (walks at same pace as others of same age)
|
6
|
|
|
3 (cannot walk as fast as others because of dyspnea)
|
8
|
|
|
4 (dyspnea after no or slight exertion)
|
10
|
|
FEV1
|
> 65%
|
0
|
|
|
49 to 65%
|
1
|
|
|
35 to 49%
|
3
|
|
|
< 35%
|
6
|
|
hospitalization
|
0
|
0
|
|
|
1
|
2
|
|
|
2
|
4
|
|
|
>= 3
|
5
|
|
age
|
<= 60
|
0
|
|
|
> 60 years
|
0.3 per year
|
where:
• The scoring for age is unclear. The scoring for age could be based either on total age or on age of 60. Based on Figure 1 the first option is used in the implementation.
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: around 38 (depending on age)
• The higher the score the more severe the COPD.
|
Total Score
|
COPD Severity
|
Respiratory Mortality Rate (Derivation/Validation)
|
|
<= 10
|
mild
|
1.9/5.1
|
|
10.1 to 14.9
|
moderate
|
5.5/7.3
|
|
15 to 19.9
|
severe
|
18.5/24.3
|
|
>= 20
|
very severe
|
49.5/49
|
Performance:
• The area under the ROC curve for year mortality is 0.79.
