It’s more than low BMI: prevalence of cachexia and associated mortality in COPD
Abstract Background Cachexia is associated with increased mortality risk among chronic obstructive pulmonary disease (COPD) patients. However, low body mass index (BMI) as opposed to cachexia is often used, particularly when calculating the BODE (BMI, Obstruction, Dyspnea and Exercise) index. For th...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-05-01
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| Series: | Respiratory Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12931-019-1073-3 |
| _version_ | 1819210429639950336 |
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| author | Merry-Lynn N. McDonald Emiel F. M. Wouters Erica Rutten Richard Casaburi Stephen I. Rennard David A. Lomas Marcas Bamman Bartolome Celli Alvar Agusti Ruth Tal-Singer Craig P. Hersh Mark Dransfield Edwin K. Silverman |
| author_facet | Merry-Lynn N. McDonald Emiel F. M. Wouters Erica Rutten Richard Casaburi Stephen I. Rennard David A. Lomas Marcas Bamman Bartolome Celli Alvar Agusti Ruth Tal-Singer Craig P. Hersh Mark Dransfield Edwin K. Silverman |
| author_sort | Merry-Lynn N. McDonald |
| collection | DOAJ |
| description | Abstract Background Cachexia is associated with increased mortality risk among chronic obstructive pulmonary disease (COPD) patients. However, low body mass index (BMI) as opposed to cachexia is often used, particularly when calculating the BODE (BMI, Obstruction, Dyspnea and Exercise) index. For this reason, we examined mortality using a consensus definition and a weight-loss definition of cachexia among COPD cases and compared two new COPD severity indices with BODE. Methods In the current report, the consensus definition for cachexia incorporated weight-loss > 5% in 12-months or low BMI in addition to 3/5 of decreased muscle strength, fatigue, anorexia, low FFMI and inflammation. The weight-loss definition incorporated weight-loss > 5% or weight-loss > 2% (if low BMI) in 12-months. The low BMI component in BODE was replaced with the consensus definition to create the CODE (Consensus cachexia, Obstruction, Dyspnea and Exercise) index and the weight-loss definition to create the WODE (Weight loss, Obstruction, Dyspnea and Exercise) index. Mortality was assessed using Kaplan-Meier survival and Cox Regression. Performance of models was compared using C-statistics. Results Among 1483 COPD cases, the prevalences of cachexia by the consensus and weight-loss definitions were 4.7 and 10.4%, respectively. Cachectic patients had a greater than three-fold increased mortality by either the consensus or the weight-loss definition of cachexia independent of BMI and lung function. The CODE index predicted mortality slightly more accurately than the BODE and WODE indices. Conclusions Cachexia is associated with increased mortality among COPD patients. Monitoring cachexia using weight-loss criteria is relatively simple and predictive of mortality among COPD cases who may be missed if only low BMI is used. |
| first_indexed | 2024-12-23T06:11:02Z |
| format | Article |
| id | doaj.art-1c85ba11211d49cea84cde762645e8ec |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-12-23T06:11:02Z |
| publishDate | 2019-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-1c85ba11211d49cea84cde762645e8ec2022-12-21T17:57:27ZengBMCRespiratory Research1465-993X2019-05-012011910.1186/s12931-019-1073-3It’s more than low BMI: prevalence of cachexia and associated mortality in COPDMerry-Lynn N. McDonald0Emiel F. M. Wouters1Erica Rutten2Richard Casaburi3Stephen I. Rennard4David A. Lomas5Marcas Bamman6Bartolome Celli7Alvar Agusti8Ruth Tal-Singer9Craig P. Hersh10Mark Dransfield11Edwin K. Silverman12Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at BirminghamCentre of expertise for chronic organ failure, Horn, the Netherlands and Department of Respiratory Medicine, Maastricht University Medical CenterCentre of expertise for chronic organ failure, Horn, the Netherlands and Department of Respiratory Medicine, Maastricht University Medical CenterRehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor Harbor-UCLA Medical CenterDepartment of Medicine, Nebraska Medical CenterUCL Respiratory, University College LondonCenter for Exercise Medicine and Departments of Cell, Developmental & Integrative Biology; Medicine; and Neurology, University of Alabama at BirminghamDivision of Pulmonary and Critical Care, Brigham and Women’s HospitalFundació Investigació Sanitària Illes Balears (FISIB), Ciber Enfermedades Respiratorias (CIBERES)GSK R&DDivision of Pulmonary and Critical Care, Brigham and Women’s HospitalDivision of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at BirminghamDivision of Pulmonary and Critical Care, Brigham and Women’s HospitalAbstract Background Cachexia is associated with increased mortality risk among chronic obstructive pulmonary disease (COPD) patients. However, low body mass index (BMI) as opposed to cachexia is often used, particularly when calculating the BODE (BMI, Obstruction, Dyspnea and Exercise) index. For this reason, we examined mortality using a consensus definition and a weight-loss definition of cachexia among COPD cases and compared two new COPD severity indices with BODE. Methods In the current report, the consensus definition for cachexia incorporated weight-loss > 5% in 12-months or low BMI in addition to 3/5 of decreased muscle strength, fatigue, anorexia, low FFMI and inflammation. The weight-loss definition incorporated weight-loss > 5% or weight-loss > 2% (if low BMI) in 12-months. The low BMI component in BODE was replaced with the consensus definition to create the CODE (Consensus cachexia, Obstruction, Dyspnea and Exercise) index and the weight-loss definition to create the WODE (Weight loss, Obstruction, Dyspnea and Exercise) index. Mortality was assessed using Kaplan-Meier survival and Cox Regression. Performance of models was compared using C-statistics. Results Among 1483 COPD cases, the prevalences of cachexia by the consensus and weight-loss definitions were 4.7 and 10.4%, respectively. Cachectic patients had a greater than three-fold increased mortality by either the consensus or the weight-loss definition of cachexia independent of BMI and lung function. The CODE index predicted mortality slightly more accurately than the BODE and WODE indices. Conclusions Cachexia is associated with increased mortality among COPD patients. Monitoring cachexia using weight-loss criteria is relatively simple and predictive of mortality among COPD cases who may be missed if only low BMI is used.http://link.springer.com/article/10.1186/s12931-019-1073-3COPDCachexiaBODEWeight lossBMI |
| spellingShingle | Merry-Lynn N. McDonald Emiel F. M. Wouters Erica Rutten Richard Casaburi Stephen I. Rennard David A. Lomas Marcas Bamman Bartolome Celli Alvar Agusti Ruth Tal-Singer Craig P. Hersh Mark Dransfield Edwin K. Silverman It’s more than low BMI: prevalence of cachexia and associated mortality in COPD Respiratory Research COPD Cachexia BODE Weight loss BMI |
| title | It’s more than low BMI: prevalence of cachexia and associated mortality in COPD |
| title_full | It’s more than low BMI: prevalence of cachexia and associated mortality in COPD |
| title_fullStr | It’s more than low BMI: prevalence of cachexia and associated mortality in COPD |
| title_full_unstemmed | It’s more than low BMI: prevalence of cachexia and associated mortality in COPD |
| title_short | It’s more than low BMI: prevalence of cachexia and associated mortality in COPD |
| title_sort | it s more than low bmi prevalence of cachexia and associated mortality in copd |
| topic | COPD Cachexia BODE Weight loss BMI |
| url | http://link.springer.com/article/10.1186/s12931-019-1073-3 |
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