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Short physical performance battery as a practical tool to assess mortality risk in chronic obstructive pulmonary disease.

Accepted version
Peer-reviewed

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Type

Article

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Authors

Fermont, Jilles M 
Mohan, Divya 
Bolton, Charlotte E 
Macnee, William 

Abstract

RATIONALE: 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. OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Description

Keywords

biomarkers, chronic obstructive pulmonary disease, mortality, older people, skeletal muscle, Aged, Cohort Studies, Exercise Tolerance, Gait, Humans, Physical Functional Performance, Pulmonary Disease, Chronic Obstructive, Severity of Illness Index, Walk Test

Journal Title

Age Ageing

Conference Name

Journal ISSN

0002-0729
1468-2834

Volume Title

50

Publisher

Oxford University Press (OUP)

Rights

All rights reserved
Sponsorship
Medical Research Council (MR/L003120/1)
British Heart Foundation (None)
British Heart Foundation (RG/18/13/33946)
This work was supported by a grant (9157-61188) from Innovate UK (formerly known as Technology Strategy Board) with contributory funding in kind from GlaxoSmithKline, a consortium partner, who also funded the corresponding author’s PhD. This work was supported by core funding from: the UK Medical Research Council (MR/L003120/1), the British Heart Foundation (RG/13/13/30194; RG/18/13/33946) and the National Institute for Health Research [Cambridge Biomedical Research Centre at the Cambridge University Hospitals NHS Foundation Trust] [*]. This work was also supported by Health Data Research UK, which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation and Wellcome. *The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.