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      Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm





    Chief Complaint


    Organ System


    Patent Pending

    BODE Index for COPD Survival

    Predicts survival in COPD patients.


    Do not use in patients during acute exacerbations of COPD. Do not use to guide therapy. See When to Use for full exclusion criteria.

    When to Use
    Why Use
    • Patients with COPD, defined as >20 pack-year smoking history and FEV1/FVC ratio <0.7, measured 20 mins after albuterol given. Do not use if any of the following:

      • Asthma diagnosis.
      • Inability to perform bronchodilator test or 6 Minute Walk Test.
      • MI within four months.
      • Unstable angina.
      • CHF (NYHA class III or IV).
      • Likely to die within 3 years from a cause other than COPD.
    • Should not be used during acute exacerbations. The DECAF Score can be used to predict mortality in acute exacerbations of COPD.
    • The BODE Index is a unique scoring system that uses variables from different domains to predict all-cause mortality and mortality from respiratory causes (respiratory failure, pneumonia or pulmonary embolism) in patients with COPD.
    • Intended for use in patients with stable COPD who are already on appropriate treatment (not acute exacerbations of COPD).
    • Requires FEV1, 6 Minute Walk Test, and mMRC Dyspnea Scale.
    • Not intended to guide or influence treatment. 
    • Better than FEV1 to predict risk of death, hospitalizations and exacerbations of COPD.
    • Widely applicable, requires no special equipment, and is simple to calculate.
    • Better than FEV1 alone at predicting mortality from any cause or respiratory cause.
    • By using the mMRC Dyspnea Scale, it takes into consideration patient’s perception of symptoms.
    • Looks at systemic manifestations of COPD by incorporating BMI and the 6 Minute Walk Test.
    • May be a better predictor of hospitalizations for COPD compared to FEV1 (Ong 2005).
    • May also be a better predictor of COPD exacerbations compared to FEV1 alone (Marin 2009).
    ≥350 m (383 yds)
    250-349 m (273-382 yds)
    150-249 m (164-272 yds)
    ≤149 m (163 yds)
    Dyspnea only with strenuous exercise
    Dyspnea when hurrying or walking up a slight hill
    Walks slower than people of same age because of dyspnea or stops for breath when walking at own pace
    Stops for breath after walking 100 yards (91 m) or after a few minutes
    Too dyspneic to leave house or breathless when dressing


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    Next Steps
    Creator Insights


    • Does not predict clinical response to therapy.
    • Does not guide therapy.
    • Best used as an adjunct to discussions with patients regarding a realistic and evidence-based picture of their prognosis.
    • Patients with a higher BODE Index have a higher risk of death from any cause and from respiratory causes (respiratory failure, pneumonia or pulmonary embolism).
    • Patients with a higher BODE Index have a greater number of COPD exacerbations and hospitalizations.


    The BODE Index is used to predict mortality and has not been studied to guide management.

    Critical Actions

    • Should not be used to guide treatment.
    • Use the BODE Index to help educate patients about their prognosis and to inform discussions regarding goals of care.
    Content Contributors
    Reviewed By
    • Robyn Scatena, MD
    About the Creator
    Dr. Bartolome R. Celli
    Content Contributors
    Reviewed By
    • Robyn Scatena, MD