Impact of comorbidities in COPD prognosys scores

Objective: Compare the prediction of mortality of the different COPD classification scores and evaluate the impact of comorbidities. Methods: 2003-2004 we included 543 COPDpatients and were followed for 5y. Comorbidities and causes of death were established from medical reports.We used GOLD and BODE scores for categorization and were also classified in 4 clusters, depending on the respiratory disease and comorbidities. Cluster analysis was performed combining multiple correspondence analyses and automatic classification. Results: we enrolled 543 patients, 96% male with a mean age of 68 years and FEV1 of 55%. 167 patients died.We identified 4 clusters depending on the main variables:respiratory and systemic. The were not differences between prediction capacity of mortality of the different scores. After adding comorbidities to GOLD/BODE the prediction of mortality improves, and if we add cardiac and kidney comorbidities, the prediction ability increased with an AUC of0.74 and 0.76 respectively (pu003c0.005). CONCLUSIONS: No differences between the different scores for prediction mortality but they improve adding comorbidities.Cardiac and kidney comorbidities were the most important for the prediction.