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Respiration. 2014;88(3):208-14. doi: 10.1159/000363770. Epub 2014 Aug 7.

The ADO index as a predictor of two-year mortality in general practice-based chronic obstructive pulmonary disease cohorts.

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1
University Clinic of Internal Medicine, Kantonsspital Baselland, Basel, Switzerland.

Abstract

BACKGROUND:

Existing prediction models for mortality in chronic obstructive pulmonary disease (COPD) patients have not yet been validated in primary care, which is where the majority of patients receive care.

OBJECTIVES:

Our aim was to validate the ADO (age, dyspnoea, airflow obstruction) index as a predictor of 2-year mortality in 2 general practice-based COPD cohorts.

METHODS:

Six hundred and forty-six patients with COPD with GOLD (Global Initiative for Chronic Obstructive Lung Disease) stages I-IV were enrolled by their general practitioners and followed for 2 years. The ADO regression equation was used to predict a 2-year risk of all-cause mortality in each patient and this risk was compared with the observed 2-year mortality. Discrimination and calibration were assessed as well as the strength of association between the 15-point ADO score and the observed 2-year all-cause mortality.

RESULTS:

Fifty-two (8.1%) patients died during the 2-year follow-up period. Discrimination with the ADO index was excellent with an area under the curve of 0.78 [95% confidence interval (CI) 0.71-0.84]. Overall, the predicted and observed risks matched well and visual inspection revealed no important differences between them across 10 risk classes (p = 0.68). The odds ratio for death per point increase according to the ADO index was 1.50 (95% CI 1.31-1.71).

CONCLUSIONS:

The ADO index showed excellent prediction properties in an out-of-population validation carried out in COPD patients from primary care settings.

PMID:
25115178
DOI:
10.1159/000363770
[Indexed for MEDLINE]
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