Short physical performance battery as a practical tool to assess mortality risk in chronic obstructive pulmonary disease.
Short physical performance battery as a practical tool to assess mortality risk in chronic obstructive pulmonary disease.
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DOI：
10.1093/ageing/afaa138
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发表时间：
2021-05-05
期刊：
影响因子：
6.7
通讯作者：
ERICA consortium
中科院分区：
文献类型：
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作者：
Fermont JM;Mohan D;Fisk M;Bolton CE;Macnee W;Cockcroft JR;McEniery C;Fuld J;Cheriyan J;Tal-Singer R;Müllerova H;Wood AM;Wilkinson IB;Polkey MI;ERICA consortium
慢性阻塞性肺病（COPD）是死亡的主要原因，在老年人中很常见。BODE指数是COPD中最受认可的死亡风险评分，但包括实践中很少使用的6分钟步行试验（6 MWT）;如果6 MWT被取代，则BODE指数可能会更好地被采用。我们调查了一种改良的BODE指数，其中6 MWT被替代的体能测量方法所取代，特别是短体能成套测试（SPPB）或其组成部分，是否保留了其对COPD患者死亡率的预测能力。我们分析了来自埃里卡队列研究的630名COPD患者，英国国家统计局证实了这些患者的死亡率数据。基线时检测的变量包括肺功能测定、6 MWT、SPPB及其组成部分（4 m步态速度试验[4 MGS]、椅子站立和平衡）。使用分层多变量考克斯回归开发预测模型，并通过C指数和10倍交叉验证和重复的校准图进行评估。在平均2年的随访期间，60例（10%）患者死亡。BODE 6 MWT的判别能力与正常人无显著性差异（C指数0.709，95%置信区间[CI]，0.680-0.737），BODESPPB（C指数0.683，95% CI，0.647-0.712）、BODE 4 MGS（C指数0.676，95% CI，0.643-0.700）和BODEBALANCE（C指数0.686，95% CI，0.651-0.713）预测死亡率。SPPB及其4 MGS和平衡分量可潜在地用作BODE指数中6 MWT的替代，而不会显著损失全因死亡率的预测能力。
chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and common in older adults. The BODE Index is the most recognised mortality risk score in COPD but includes a 6-minute walk test (6MWT) that is seldom available in practise; the BODE Index may be better adopted if the 6MWT was replaced. we investigated whether a modified BODE Index in which 6MWT was replaced by an alternative measure of physical capacity, specifically the short physical performance battery (SPPB) or components, retained its predictive ability for mortality in individuals with COPD. we analysed 630 COPD patients from the ERICA cohort study for whom UK Office for National Statistics verified mortality data were available. Variables tested at baseline included spirometry, 6MWT, SPPB and its components (4-m gait speed test [4MGS], chair stand and balance). Predictive models were developed using stratified multivariable Cox regression, and assessed by C-indices and calibration plots with 10-fold cross-validation and replication. during median 2 years of follow-up, 60 (10%) individuals died. There was no significant difference between the discriminative ability of BODE6MWT (C-index 0.709, 95% confidence interval [CI], 0.680–0.737), BODESPPB (C-index 0.683, 95% CI, 0.647–0.712), BODE4MGS (C-index 0.676, 95% CI, 0.643–0.700) and BODEBALANCE (C-index 0.686, 95% CI, 0.651–0.713) for predicting mortality. the SPPB, and its 4MGS and balance components, can potentially be used as an alternative to the 6MWT in the BODE Index without significant loss of predictive ability in all-cause mortality.