Risk charts of five-year mortality in COPD patients

Background: Different multidimensional grading systems have been used to predict mortality in COPD patients. However, some are with poor calibration or too complex for daily use. As part of the COPD Cohorts Collaborative International Assessment (3CIA) initiative, we aimed to develop a risk scoring system for the management of COPD patients in daily clinical practice based on readily available parameters. Methods: A pooled dataset of 26 COPD cohorts from 9 countries was used. A step-wise selection of covariates influencing mortality was performed using a semiparametric cox proportional hazards model. Covariates included were: age, FEV1, GOLD(A-D), exacerbation history, mMRC, BMI, cough, sputum, wheeze, St.-George’s-Respiratory-Questionnaire, diabetes, chronic bronchitis, arterial hypertension, and previous asthma. Five-year risk of all-cause mortality was calculated afterwards. Results: 16,973 subjects (68.9% men) older than 40 years of age representing 88,181 person-years of follow-up were included. Mean age was 64.4±9.8 years and 95.7% were former or current smokers. A total of 4,765 deaths of all-cause was observed. The following covariates were selected to be included in the model: sex, age, FEV1, mMRC, and BMI. The risk estimations were displayed graphically in simple risk charts (Figure 1). Conclusion: We present a risk estimation tool for COPD patients in an easy-to-use format suitable for clinicians in daily clinical practice.