Using the DOSE index to predict changes in health status and hospitalisation of COPD patients

Background The FEV1 is associated with increased mortality and used for severity classification of COPD worldwide. A multicomponent index – like the DOSE index - has the potential to predict important future outcome in patients with COPD better than the FEV1. Aims and objectives The aim of our study was to investigate if the DOSE index can predict which patients are at risk for a clinically relevant change in health status and hospitalisation (1). Methods A prospective cohort study was done with data from primary care and secondary care. The DOSE score (dyspnea score (D), level of airflow obstruction (O), current smoking status (S) and exacerbations (E)) was determined at baseline and the 2-year change in Clinical COPD Questionnaire (CCQ)-score was calculated as well as COPD hospitalisation risk in the second year of follow-up. Linear regression analysis was performed for the effect of a high DOSE score (i.e. ≥4) on change in CCQ score. Chi-square was used to test difference in hospitalisation risk based on this DOSE cut-off point. Results The study population consisted of 209 patients (112 patients from primary care). Overall a high DOSE score was a significant predictor for a change in CCQ score after 2 years (0.41, 95%CI; 0.13, 0.70), in particular in primary care patients. Significant more patients were hospitalised with a DOSE-score ≥4. (28.0%) compared to a lower DOSE score (2.7%; p<0.01). Conclusions A DOSE score ≥4 has the ability to identify COPD patients with a greater risk on future worsening in health status and hospitalisation risk. 1) Rolink M. et al. Using the DOSE index to predict changes in health status of COPD patients. Primary Care Respiratory Journal (In press).