Adrenomedullin refines mortality prediction by the BODE index in COPD: the "BODE-A" index.

The BODE index is well-validated for mortality prediction in COPD. of plasma proadrenomedullin, a surrogate for mature adrenomedullin, predicted 2-year mortality among inpatients with COPD exacerbation.We accuracy of initial proadrenomedullin level, BODE, and BODE components, combined, in predicting 1-year or 2-year all-cause mortality in a multinational observational cohort with stable, moderate to very severe COPD.Proadrenomedullin was significantly associated (P<0.001) with 1- mortality (4.7%) and 2-year mortality (7.8%), and comparably predictive regarding both (C statistics: 0.691 vs. 0.745, 0.635 vs. 0.679). using BODE alone, adding proadrenomedullin significantly improved 1-year 2-year mortality prognostication (C statistics: 0.750, 0.818; both Proadrenomedullin plus BOD was more predictive than was the original including 6-minute-walk distance. In multivariable analysis, (LR X2 13.0, P<0.001), body mass index (8.5, P=0.004), and 6-minute-walk (7.5, P=0.006), but not modified MMRC dyspnoea score (2.2, P=0.14) or predicted (0.3, P=0.60), independently foretold 2-year plus BODE better predicts mortality in COPD patients than does BODE proadrenomedullin may substitute for 6-minute-walk distance in BODE when 6-minute-walk testing is unavailable