The stability of the ADO score among UK COPD patients from The Health Improvement Network
The ADO (age, dyspnoea, airflow obstruction) score predicts 3-year overall mortality among chronic obstructive pulmonary disease (COPD) patients. Information on the changes in COPD prognostic scores is sparse and it is unclear if the ADO score should be measured serially. We followed 4804 UK COPD pa...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2020-02-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/6/1/00196-2019.full |
| _version_ | 1818985940745453568 |
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| author | Spencer J. Keene Peymane Adab Frank de Vries Frits M.E. Franssen Alice Sitch James Martin Tom Marshall Rachel Jordan |
| author_facet | Spencer J. Keene Peymane Adab Frank de Vries Frits M.E. Franssen Alice Sitch James Martin Tom Marshall Rachel Jordan |
| author_sort | Spencer J. Keene |
| collection | DOAJ |
| description | The ADO (age, dyspnoea, airflow obstruction) score predicts 3-year overall mortality among chronic obstructive pulmonary disease (COPD) patients. Information on the changes in COPD prognostic scores is sparse and it is unclear if the ADO score should be measured serially. We followed 4804 UK COPD patients with three or more ADO measurements from The Health Improvement Network (2005–2014) in a retrospective open cohort design. Patient's ADO scores were calculated once per year unless an obstruction or dyspnoea measurement was missing. Cox regression models assessed the independent role of serial ADO scores on mortality. The associations between baseline patient characteristics and long-term change in ADO scores were assessed using linear mixed effect models. Fewer than 7% of patients had worsened (i.e. increased) by ≥1 point per year after a median follow-up of 4.4 years. There was strong evidence that patients with more rapid worsening in ADO scores had increased mortality (hazard ratio 2.00 (95% CI 1.59–2.52) per 1 point increase in ADO per year). More rapid ADO score worsening was seen among current smokers (rate difference 0.059 (95% CI 0.031–0.087); p=0.001) and ex-smokers (0.028 (95% CI 0.003–0.054); p=0.032) and patients with depression (0.038 (95% CI 0.005–0.071); p=0.022), while overweight (−0.0347 (95% CI −0.0544– −0.0150); p=0.001) and obese (−0.0412 (95% CI −0.0625– −0.0198); p<0.001) patients had a less rapid ADO score worsening. Serial assessment of the ADO score can identify patients with worsening disease and update their prognosis, especially for patients who smoke, are depressed or have lower body mass index. |
| first_indexed | 2024-12-20T18:42:53Z |
| format | Article |
| id | doaj.art-22a8c86ddf6e491fa11c76607f681ba0 |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-12-20T18:42:53Z |
| publishDate | 2020-02-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-22a8c86ddf6e491fa11c76607f681ba02022-12-21T19:29:46ZengEuropean Respiratory SocietyERJ Open Research2312-05412020-02-016110.1183/23120541.00196-201900196-2019The stability of the ADO score among UK COPD patients from The Health Improvement NetworkSpencer J. Keene0Peymane Adab1Frank de Vries2Frits M.E. Franssen3Alice Sitch4James Martin5Tom Marshall6Rachel Jordan7 Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK Dept of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands CIRO+, Horn, The Netherlands Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK The ADO (age, dyspnoea, airflow obstruction) score predicts 3-year overall mortality among chronic obstructive pulmonary disease (COPD) patients. Information on the changes in COPD prognostic scores is sparse and it is unclear if the ADO score should be measured serially. We followed 4804 UK COPD patients with three or more ADO measurements from The Health Improvement Network (2005–2014) in a retrospective open cohort design. Patient's ADO scores were calculated once per year unless an obstruction or dyspnoea measurement was missing. Cox regression models assessed the independent role of serial ADO scores on mortality. The associations between baseline patient characteristics and long-term change in ADO scores were assessed using linear mixed effect models. Fewer than 7% of patients had worsened (i.e. increased) by ≥1 point per year after a median follow-up of 4.4 years. There was strong evidence that patients with more rapid worsening in ADO scores had increased mortality (hazard ratio 2.00 (95% CI 1.59–2.52) per 1 point increase in ADO per year). More rapid ADO score worsening was seen among current smokers (rate difference 0.059 (95% CI 0.031–0.087); p=0.001) and ex-smokers (0.028 (95% CI 0.003–0.054); p=0.032) and patients with depression (0.038 (95% CI 0.005–0.071); p=0.022), while overweight (−0.0347 (95% CI −0.0544– −0.0150); p=0.001) and obese (−0.0412 (95% CI −0.0625– −0.0198); p<0.001) patients had a less rapid ADO score worsening. Serial assessment of the ADO score can identify patients with worsening disease and update their prognosis, especially for patients who smoke, are depressed or have lower body mass index.http://openres.ersjournals.com/content/6/1/00196-2019.full |
| spellingShingle | Spencer J. Keene Peymane Adab Frank de Vries Frits M.E. Franssen Alice Sitch James Martin Tom Marshall Rachel Jordan The stability of the ADO score among UK COPD patients from The Health Improvement Network ERJ Open Research |
| title | The stability of the ADO score among UK COPD patients from The Health Improvement Network |
| title_full | The stability of the ADO score among UK COPD patients from The Health Improvement Network |
| title_fullStr | The stability of the ADO score among UK COPD patients from The Health Improvement Network |
| title_full_unstemmed | The stability of the ADO score among UK COPD patients from The Health Improvement Network |
| title_short | The stability of the ADO score among UK COPD patients from The Health Improvement Network |
| title_sort | stability of the ado score among uk copd patients from the health improvement network |
| url | http://openres.ersjournals.com/content/6/1/00196-2019.full |
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