TY - JOUR
T1 - External Validation and Recalculation of the CODEX Index in COPD Patients. A 3CIAplus Cohort Study
AU - for the 3CIA collaboration
AU - Almagro, Pere
AU - Martínez-Camblor, Pablo
AU - Miravitlles, Marc
AU - Rodríguez-Carballeira, Mónica
AU - Navarro, Annie
AU - Lamprecht, Bernd
AU - Ramirez-Garcia Luna, Ana S.
AU - Kaiser, Bernhard
AU - Alfageme, Inmaculada
AU - Casanova, Ciro
AU - Esteban, Cristobal
AU - Soler-Cataluña, Juan J.
AU - de-Torres, Juan P.
AU - Celli, Bartolome R.
AU - Marin, Jose M.
AU - ter Riet, Gerben
AU - Sobradillo, Patricia
AU - Lange, Peter
AU - Garcia-Aymerich, Judith
AU - Anto, Josep M.
AU - Turner, Alice M.
AU - Han, Mei Lan K.
AU - Langhammer, Arnulf
AU - Sternberg, Alice
AU - Leivseth, Linda
AU - Bakke, Per
AU - Johannessen, Ane
AU - Oga, Toru
AU - Cosío, Borja
AU - Ancochea, Julio
AU - Echazarreta, Andres
AU - Roche, Nicolas
AU - Burgel, Pierre Régis
AU - Sin, Don D.
AU - Puhan, Milo A.
AU - Soriano, Joan B.
N1 - Publisher Copyright:
© 2018, © 2018 Taylor & Francis Group, LLC.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - The CODEX index was developed and validated in patients hospitalized for COPD exacerbation to predict the risk of death and readmission within one year after discharge. Our study aimed to validate the CODEX index in a large external population of COPD patients with variable durations of follow-up. Additionally, we aimed to recalculate the thresholds of the CODEX index using the cutoffs of variables previously suggested in the 3CIA study (mCODEX). Individual data on 2,755 patients included in the COPD Cohorts Collaborative International Assessment Plus (3CIA+) were explored. A further two cohorts (ESMI AND EGARPOC-2) were added. To validate the CODEX index, the relationship between mortality and the CODEX index was assessed using cumulative/dynamic ROC curves at different follow-up periods, ranging from 3 months up to 10 years. Calibration was performed using univariate and multivariate Cox proportional hazard models and Hosmer-Lemeshow test. A total of 3,321 (87.8% males) patients were included with a mean ± SD age of 66.9 ± 10.5 years, and a median follow-up of 1,064 days (IQR 25–75% 426–1643), totaling 11,190 person-years. The CODEX index was statistically associated with mortality in the short- (≤3 months), medium- (≤1 year) and long-term (10 years), with an area under the curve of 0.72, 0.70 and 0.76, respectively. The mCODEX index performed better in the medium-term (<1 year) than the original CODEX, and similarly in the long-term. In conclusion, CODEX and mCODEX index are good predictors of mortality in patients with COPD, regardless of disease severity or duration of follow-up.
AB - The CODEX index was developed and validated in patients hospitalized for COPD exacerbation to predict the risk of death and readmission within one year after discharge. Our study aimed to validate the CODEX index in a large external population of COPD patients with variable durations of follow-up. Additionally, we aimed to recalculate the thresholds of the CODEX index using the cutoffs of variables previously suggested in the 3CIA study (mCODEX). Individual data on 2,755 patients included in the COPD Cohorts Collaborative International Assessment Plus (3CIA+) were explored. A further two cohorts (ESMI AND EGARPOC-2) were added. To validate the CODEX index, the relationship between mortality and the CODEX index was assessed using cumulative/dynamic ROC curves at different follow-up periods, ranging from 3 months up to 10 years. Calibration was performed using univariate and multivariate Cox proportional hazard models and Hosmer-Lemeshow test. A total of 3,321 (87.8% males) patients were included with a mean ± SD age of 66.9 ± 10.5 years, and a median follow-up of 1,064 days (IQR 25–75% 426–1643), totaling 11,190 person-years. The CODEX index was statistically associated with mortality in the short- (≤3 months), medium- (≤1 year) and long-term (10 years), with an area under the curve of 0.72, 0.70 and 0.76, respectively. The mCODEX index performed better in the medium-term (<1 year) than the original CODEX, and similarly in the long-term. In conclusion, CODEX and mCODEX index are good predictors of mortality in patients with COPD, regardless of disease severity or duration of follow-up.
KW - COPD
KW - Prognosis
KW - comorbidities
KW - mortality
KW - multicomponent index
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=85062980198&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062980198&partnerID=8YFLogxK
U2 - 10.1080/15412555.2018.1484440
DO - 10.1080/15412555.2018.1484440
M3 - Article
C2 - 30870059
AN - SCOPUS:85062980198
SN - 1541-2555
JO - COPD: Journal of Chronic Obstructive Pulmonary Disease
JF - COPD: Journal of Chronic Obstructive Pulmonary Disease
ER -