The development of the ADO-SQ model to predict 1-year mortality in patients with COPD.

Autor:	Owusuaa C; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., van der Leest C; Department of Pulmonary Diseases, Amphia Hospital, Breda, The Netherlands., Helfrich G; Department of Pulmonary Diseases, Maasstad Hospital, Rotterdam, The Netherlands., Heller-Baan R; Department of Pulmonary Diseases, Ikazia Hospital, Rotterdam, The Netherlands., Loenhout CV; Department of Pulmonary Diseases, Admiraal De Ruyter Hospital, Goes, The Netherlands., Herbrink JW; Department of Pulmonary Diseases, Van Weel Bethesda Hospital, Dirksland, The Netherlands., Nieboer D; Department of Public Health, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands., van der Rijt CC; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., van der Heide A; Department of Public Health, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Palliative medicine [Palliat Med] 2022 May; Vol. 36 (5), pp. 821-829. Date of Electronic Publication: 2022 Mar 24.
DOI:	10.1177/02692163221080662
Abstrakt:	Background: Goals of end-of-life care must be adapted to the needs of patients with chronic obstructive pulmonary disease (COPD) who are in the last phase of life. However, identification of those patients is limited by moderate performances of existing prognostic models and by limited validation of the often-recommended surprise question. Aim: To develop a clinical prediction model to predict 1-year mortality in patients with COPD. Design: Prospective study using logistic regression to develop a model in two steps: (1) external validation of the ADO, BODEX, or CODEX models (A = age; B = body mass index; C = comorbidity; D = dyspnea; EX = exacerbations; O = airflow obstruction); (2) updating of best performing model and extending it with the surprise question. Discriminative performance of the new model was assessed using internal-external validation and measured with area under the curve (AUC). A nomogram and web application were developed. Settings/participants: Patients with COPD from five hospitals (September-November 2017). Results: Of the 358 included patients (median age 69.5 years, 50% male), 63 (17%) died within a year. The ADO index (AUC 0.73) had the best discriminative ability compared to the BODEX (AUC 0.71) or CODEX (AUC 0.68), and was extended with the surprise question. The resulting ADO-surprise question (SQ) model had an AUC of 0.79. Conclusion: The ADO-SQ model offers improved discriminative performance for predicting 1-year mortality compared to the surprise question, ADO, BODEX, or CODEX. A user-friendly nomogram and web application (https://dnieboer.shinyapps.io/copd) were developed. Further external validation of the ADO-SQ in patient groups is needed.
Databáze:	MEDLINE
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