External Validation and Recalculation of the CODEX Index in COPD Patients. A 3CIAplus Cohort Study

Peter Lange; Pere Almagro; Pablo Martínez-Camblor; Marc Miravitlles; Mónica Rodríguez-Carballeira; Annie Navarro; Bernd Lamprecht; Ana S Ramirez-Garcia Luna; Bernhard Kaiser; Inmaculada Alfageme; Ciro Casanova; Cristobal Esteban; Juan J Soler-Cataluña; Juan P de-Torres; Bartolome R Celli; Jose M Marin; Gerben Ter Riet; Patricia Sobradillo; Judith Garcia-Aymerich; Josep M Anto; Alice M Turner; MeiLan K Han; Arnulf Langhammer; Alice Sternberg; Linda Leivseth; Per Bakke; Ane Johannessen; Toru Oga; Borja Cosío; Julio Ancochea; Andres Echazarreta; Nicolas Roche; Pierre-Régis Burgel; Don D Sin; Milo A Puhan; Joan B Soriano; 3CIA collaboration

doi:10.1080/15412555.2018.1484440

External Validation and Recalculation of the CODEX Index in COPD Patients. A 3CIAplus Cohort Study

Peter Lange, Pere Almagro, Pablo Martínez-Camblor, Marc Miravitlles, Mónica Rodríguez-Carballeira, Annie Navarro, Bernd Lamprecht, Ana S Ramirez-Garcia Luna, Bernhard Kaiser, Inmaculada Alfageme, Ciro Casanova, Cristobal Esteban, Juan J Soler-Cataluña, Juan P de-Torres, Bartolome R Celli, Jose M Marin, Gerben Ter Riet, Patricia Sobradillo, Judith Garcia-Aymerich, Josep M AntoAlice M Turner, MeiLan K Han, Arnulf Langhammer, Alice Sternberg, Linda Leivseth, Per Bakke, Ane Johannessen, Toru Oga, Borja Cosío, Julio Ancochea, Andres Echazarreta, Nicolas Roche, Pierre-Régis Burgel, Don D Sin, Milo A Puhan, Joan B Soriano, 3CIA collaboration

Copenhagen City Heart Study

Abstract

The CODEX index was developed and validated in patients hospitalized for COPD exacerbation to predict the risk of death and readmission within one year after discharge. Our study aimed to validate the CODEX index in a large external population of COPD patients with variable durations of follow-up. Additionally, we aimed to recalculate the thresholds of the CODEX index using the cutoffs of variables previously suggested in the 3CIA study (mCODEX). Individual data on 2,755 patients included in the COPD Cohorts Collaborative International Assessment Plus (3CIA+) were explored. A further two cohorts (ESMI AND EGARPOC-2) were added. To validate the CODEX index, the relationship between mortality and the CODEX index was assessed using cumulative/dynamic ROC curves at different follow-up periods, ranging from 3 months up to 10 years. Calibration was performed using univariate and multivariate Cox proportional hazard models and Hosmer-Lemeshow test. A total of 3,321 (87.8% males) patients were included with a mean ± SD age of 66.9 ± 10.5 years, and a median follow-up of 1,064 days (IQR 25-75% 426-1643), totaling 11,190 person-years. The CODEX index was statistically associated with mortality in the short- (≤3 months), medium- (≤1 year) and long-term (10 years), with an area under the curve of 0.72, 0.70 and 0.76, respectively. The mCODEX index performed better in the medium-term (<1 year) than the original CODEX, and similarly in the long-term. In conclusion, CODEX and mCODEX index are good predictors of mortality in patients with COPD, regardless of disease severity or duration of follow-up.

Original language	English
Journal	COPD
Volume	16
Issue number	1
Pages (from-to)	8-17
Number of pages	10
ISSN	1541-2555
DOIs	https://doi.org/10.1080/15412555.2018.1484440
Publication status	Published - Feb 2019

Keywords

Aged
Area Under Curve
Calibration
Cohort Studies
Comorbidity
Disease Progression
Dyspnea/etiology
Female
Follow-Up Studies
Forced Expiratory Volume
Humans
Lung Diseases, Obstructive/complications
Male
Middle Aged
Proportional Hazards Models
ROC Curve
Risk Assessment/methods
Symptom Flare Up
Time Factors

Access to Document

10.1080/15412555.2018.1484440

Cite this

Lange, P., Almagro, P., Martínez-Camblor, P., Miravitlles, M., Rodríguez-Carballeira, M., Navarro, A., Lamprecht, B., Ramirez-Garcia Luna, A. S., Kaiser, B., Alfageme, I., Casanova, C., Esteban, C., Soler-Cataluña, J. J., de-Torres, J. P., Celli, B. R., Marin, J. M., Ter Riet, G., Sobradillo, P., Garcia-Aymerich, J., ... 3CIA collaboration (2019). External Validation and Recalculation of the CODEX Index in COPD Patients. A 3CIAplus Cohort Study. COPD, 16(1), 8-17. https://doi.org/10.1080/15412555.2018.1484440

Lange, P, Almagro, P, Martínez-Camblor, P, Miravitlles, M, Rodríguez-Carballeira, M, Navarro, A, Lamprecht, B, Ramirez-Garcia Luna, AS, Kaiser, B, Alfageme, I, Casanova, C, Esteban, C, Soler-Cataluña, JJ, de-Torres, JP, Celli, BR, Marin, JM, Ter Riet, G, Sobradillo, P, Garcia-Aymerich, J, Anto, JM, Turner, AM, Han, MK, Langhammer, A, Sternberg, A, Leivseth, L, Bakke, P, Johannessen, A, Oga, T, Cosío, B, Ancochea, J, Echazarreta, A, Roche, N, Burgel, P-R, Sin, DD, Puhan, MA, Soriano, JB & 3CIA collaboration 2019, 'External Validation and Recalculation of the CODEX Index in COPD Patients. A 3CIAplus Cohort Study', COPD, vol. 16, no. 1, pp. 8-17. https://doi.org/10.1080/15412555.2018.1484440

@article{3feaf9add9ab4ab6a15fc3e7700731be,

title = "External Validation and Recalculation of the CODEX Index in COPD Patients. A 3CIAplus Cohort Study",

abstract = "The CODEX index was developed and validated in patients hospitalized for COPD exacerbation to predict the risk of death and readmission within one year after discharge. Our study aimed to validate the CODEX index in a large external population of COPD patients with variable durations of follow-up. Additionally, we aimed to recalculate the thresholds of the CODEX index using the cutoffs of variables previously suggested in the 3CIA study (mCODEX). Individual data on 2,755 patients included in the COPD Cohorts Collaborative International Assessment Plus (3CIA+) were explored. A further two cohorts (ESMI AND EGARPOC-2) were added. To validate the CODEX index, the relationship between mortality and the CODEX index was assessed using cumulative/dynamic ROC curves at different follow-up periods, ranging from 3 months up to 10 years. Calibration was performed using univariate and multivariate Cox proportional hazard models and Hosmer-Lemeshow test. A total of 3,321 (87.8% males) patients were included with a mean ± SD age of 66.9 ± 10.5 years, and a median follow-up of 1,064 days (IQR 25-75% 426-1643), totaling 11,190 person-years. The CODEX index was statistically associated with mortality in the short- (≤3 months), medium- (≤1 year) and long-term (10 years), with an area under the curve of 0.72, 0.70 and 0.76, respectively. The mCODEX index performed better in the medium-term (<1 year) than the original CODEX, and similarly in the long-term. In conclusion, CODEX and mCODEX index are good predictors of mortality in patients with COPD, regardless of disease severity or duration of follow-up.",

keywords = "Aged, Area Under Curve, Calibration, Cohort Studies, Comorbidity, Disease Progression, Dyspnea/etiology, Female, Follow-Up Studies, Forced Expiratory Volume, Humans, Lung Diseases, Obstructive/complications, Male, Middle Aged, Proportional Hazards Models, ROC Curve, Risk Assessment/methods, Symptom Flare Up, Time Factors",

author = "Peter Lange and Pere Almagro and Pablo Mart{\'i}nez-Camblor and Marc Miravitlles and M{\'o}nica Rodr{\'i}guez-Carballeira and Annie Navarro and Bernd Lamprecht and {Ramirez-Garcia Luna}, {Ana S} and Bernhard Kaiser and Inmaculada Alfageme and Ciro Casanova and Cristobal Esteban and Soler-Catalu{\~n}a, {Juan J} and de-Torres, {Juan P} and Celli, {Bartolome R} and Marin, {Jose M} and {Ter Riet}, Gerben and Patricia Sobradillo and Judith Garcia-Aymerich and Anto, {Josep M} and Turner, {Alice M} and Han, {MeiLan K} and Arnulf Langhammer and Alice Sternberg and Linda Leivseth and Per Bakke and Ane Johannessen and Toru Oga and Borja Cos{\'i}o and Julio Ancochea and Andres Echazarreta and Nicolas Roche and Pierre-R{\'e}gis Burgel and Sin, {Don D} and Puhan, {Milo A} and Soriano, {Joan B} and {3CIA collaboration}",

year = "2019",

month = feb,

doi = "10.1080/15412555.2018.1484440",

language = "English",

volume = "16",

pages = "8--17",

journal = "COPD",

issn = "1541-2555",

publisher = "Informa Healthcare",

number = "1",

}

TY - JOUR

T1 - External Validation and Recalculation of the CODEX Index in COPD Patients. A 3CIAplus Cohort Study

AU - Lange, Peter

AU - Almagro, Pere

AU - Martínez-Camblor, Pablo

AU - Miravitlles, Marc

AU - Rodríguez-Carballeira, Mónica

AU - Navarro, Annie

AU - Lamprecht, Bernd

AU - Ramirez-Garcia Luna, Ana S

AU - Kaiser, Bernhard

AU - Alfageme, Inmaculada

AU - Casanova, Ciro

AU - Esteban, Cristobal

AU - Soler-Cataluña, Juan J

AU - de-Torres, Juan P

AU - Celli, Bartolome R

AU - Marin, Jose M

AU - Ter Riet, Gerben

AU - Sobradillo, Patricia

AU - Garcia-Aymerich, Judith

AU - Anto, Josep M

AU - Turner, Alice M

AU - Han, MeiLan K

AU - Langhammer, Arnulf

AU - Sternberg, Alice

AU - Leivseth, Linda

AU - Bakke, Per

AU - Johannessen, Ane

AU - Oga, Toru

AU - Cosío, Borja

AU - Ancochea, Julio

AU - Echazarreta, Andres

AU - Roche, Nicolas

AU - Burgel, Pierre-Régis

AU - Sin, Don D

AU - Puhan, Milo A

AU - Soriano, Joan B

AU - 3CIA collaboration

PY - 2019/2

Y1 - 2019/2

N2 - The CODEX index was developed and validated in patients hospitalized for COPD exacerbation to predict the risk of death and readmission within one year after discharge. Our study aimed to validate the CODEX index in a large external population of COPD patients with variable durations of follow-up. Additionally, we aimed to recalculate the thresholds of the CODEX index using the cutoffs of variables previously suggested in the 3CIA study (mCODEX). Individual data on 2,755 patients included in the COPD Cohorts Collaborative International Assessment Plus (3CIA+) were explored. A further two cohorts (ESMI AND EGARPOC-2) were added. To validate the CODEX index, the relationship between mortality and the CODEX index was assessed using cumulative/dynamic ROC curves at different follow-up periods, ranging from 3 months up to 10 years. Calibration was performed using univariate and multivariate Cox proportional hazard models and Hosmer-Lemeshow test. A total of 3,321 (87.8% males) patients were included with a mean ± SD age of 66.9 ± 10.5 years, and a median follow-up of 1,064 days (IQR 25-75% 426-1643), totaling 11,190 person-years. The CODEX index was statistically associated with mortality in the short- (≤3 months), medium- (≤1 year) and long-term (10 years), with an area under the curve of 0.72, 0.70 and 0.76, respectively. The mCODEX index performed better in the medium-term (<1 year) than the original CODEX, and similarly in the long-term. In conclusion, CODEX and mCODEX index are good predictors of mortality in patients with COPD, regardless of disease severity or duration of follow-up.

AB - The CODEX index was developed and validated in patients hospitalized for COPD exacerbation to predict the risk of death and readmission within one year after discharge. Our study aimed to validate the CODEX index in a large external population of COPD patients with variable durations of follow-up. Additionally, we aimed to recalculate the thresholds of the CODEX index using the cutoffs of variables previously suggested in the 3CIA study (mCODEX). Individual data on 2,755 patients included in the COPD Cohorts Collaborative International Assessment Plus (3CIA+) were explored. A further two cohorts (ESMI AND EGARPOC-2) were added. To validate the CODEX index, the relationship between mortality and the CODEX index was assessed using cumulative/dynamic ROC curves at different follow-up periods, ranging from 3 months up to 10 years. Calibration was performed using univariate and multivariate Cox proportional hazard models and Hosmer-Lemeshow test. A total of 3,321 (87.8% males) patients were included with a mean ± SD age of 66.9 ± 10.5 years, and a median follow-up of 1,064 days (IQR 25-75% 426-1643), totaling 11,190 person-years. The CODEX index was statistically associated with mortality in the short- (≤3 months), medium- (≤1 year) and long-term (10 years), with an area under the curve of 0.72, 0.70 and 0.76, respectively. The mCODEX index performed better in the medium-term (<1 year) than the original CODEX, and similarly in the long-term. In conclusion, CODEX and mCODEX index are good predictors of mortality in patients with COPD, regardless of disease severity or duration of follow-up.

KW - Aged

KW - Area Under Curve

KW - Calibration

KW - Cohort Studies

KW - Comorbidity

KW - Disease Progression

KW - Dyspnea/etiology

KW - Female

KW - Follow-Up Studies

KW - Forced Expiratory Volume

KW - Humans

KW - Lung Diseases, Obstructive/complications

KW - Male

KW - Middle Aged

KW - Proportional Hazards Models

KW - ROC Curve

KW - Risk Assessment/methods

KW - Symptom Flare Up

KW - Time Factors

U2 - 10.1080/15412555.2018.1484440

DO - 10.1080/15412555.2018.1484440

M3 - Journal article

C2 - 30870059

SN - 1541-2555

VL - 16

SP - 8

EP - 17

JO - COPD

JF - COPD

IS - 1

ER -

External Validation and Recalculation of the CODEX Index in COPD Patients. A 3CIAplus Cohort Study

Abstract

Keywords

Access to Document

Fingerprint

Cite this