Purpose: The BODE Index (BI) is a 10-point scoring system divided into quartiles developed to identify the mortality risk of chronic obstruction pulmonary disease (COPD) patients. Components of the BI are Body Mass Index (BMI), degree of obstruction measured by forced expiratory volume in first second (FEV1) measured in percent, score obtained on the Medical Research Council dyspnea scale (MRC), and distance (in meters) walking during 6-minute walk (6MWD). The principal objective of this study was to investigate whether the BI can be a viable outcome tool for a comprehensive COPD pulmonary rehabilitation program (CPRP). Additional study questions included how the CPRP effect patient's BI score and mortality risk.
Methods: Twenty-eight consecutive COPD patients enrolled in a 2-month CPRP. Pre- and post-CPRP evaluations made during the initial and final week of each patient's program included measurements of BMI, FEV1, MRC, and 6MWD. Patients' measurements were then awarded points using the BI format. T-tests analysis was then undertaken for the pre- and postmeasurements of BMI, FEV1, MRC, 6MWD, and BI. Pre- and postcomponents and cumulative quartile score of the BI were then analyzed for changes.
Results: Statistical analysis revealed no significant differences (P > .05) between pre- and postmeasurements of BMI (31.2 +/- 9.2; 31.3 +/- 9.2), FEV1 (0.46 +/- 0.18; 0.43 +/- 0.17), and MRC (1.61 +/- 1.03; 1.11 +/- 0.92). Significant differences (P < .05) were noted for pre- and postmeasurements of 6MWD (284.7 +/- 110.6; 323.4 +/- 107.6) and BI scores (4.65 +/- 2.39; 3.89 +/- 2.27). Review of pre- to post-BI components by patient demonstrated (a) no BI score changes for BMI; (b) 3 BI scores improved and 8 declined in FEV1; (c) 12 BI scores improved and one declined in MRC, and (d) 13 BI scores improved and one declined in 6MWD. Cumulative BI component scores revealed 9 patients improved at least 1 BI quartile from pre- to post-CPRP.
Conclusion: This investigation revealed patients who complete a CPRP can change individual component points in one category (6MWD) and improve their BI score. The other 3 categories (BMI, FEV1, and MRC) showed little response to our CPRP. Further investigation is needed to determine if the BI is a viable outcomes tool for pulmonary rehabilitation programs.