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BODE Index — COPD Mortality Prediction
Pulmonology / COPD
The BODE index is a multidimensional grading system for COPD that predicts 4-year all-cause and respiratory mortality. It incorporates BMI, airflow obstruction (FEV₁), dyspnea (mMRC), and exercise capacity (6MWD). Scores range from 0 to 10.
B
BMI
—
/1
O
Obstruction
—
/3
D
Dyspnea
—
/3
E
Exercise
—
/3
B — BMI Component
BMI will calculate automatically
O — Airflow Obstruction (FEV₁)
GOLD stage will appear here
D — Dyspnea (mMRC Scale)
E — Exercise Capacity (6-Minute Walk)
Formula
B: BMI = Weight (kg) / Height (m)² [≤21 → 1pt | >21 → 0pts]
O: FEV₁ % predicted [≥65%→0 | 50–64%→1 | 36–49%→2 | ≤35%→3]
D: mMRC grade [0–1→0pts | 2→1pt | 3→2pts | 4→3pts]
E: 6MWD (m) [≥350→0 | 250–349→1 | 150–249→2 | ≤149→3]
O: FEV₁ % predicted [≥65%→0 | 50–64%→1 | 36–49%→2 | ≤35%→3]
D: mMRC grade [0–1→0pts | 2→1pt | 3→2pts | 4→3pts]
E: 6MWD (m) [≥350→0 | 250–349→1 | 150–249→2 | ≤149→3]
BODE Score Reference
| BODE Score | Quartile | 4-Year Mortality | Notes |
|---|---|---|---|
| 0–2 | 1 | 15.2% | Low risk |
| 3–4 | 2 | 30.2% | Moderate risk |
| 5–6 | 3 | 40.1% | High risk — consider referral |
| 7–10 | 4 | >80% | Very high — transplant evaluation |
GOLD Stage Reference
| FEV₁ % Predicted | GOLD Stage | Severity |
|---|---|---|
| ≥80% | GOLD 1 | Mild |
| 50–79% | GOLD 2 | Moderate |
| 30–49% | GOLD 3 | Severe |
| <30% | GOLD 4 | Very Severe |
mMRC Dyspnea Scale
| Grade | Description | BODE Points |
|---|---|---|
| 0 | Breathless only with strenuous exercise | 0 |
| 1 | Short of breath when hurrying or on slight incline | 0 |
| 2 | Walks slower than peers or stops on level ground | 1 |
| 3 | Stops for breath after ~100m or a few minutes | 2 |
| 4 | Too breathless to leave house or when dressing | 3 |
Clinical Notes
The BODE index is superior to FEV₁ alone in predicting mortality in COPD. It captures the systemic nature of COPD beyond pulmonary function.
BODE ≥5: Consider referral for lung transplant evaluation. BODE 5–6 is a common threshold used by transplant centers. Most centers require BODE ≥7 for listing.
Pulmonary rehabilitation can improve 6MWD and mMRC grade, potentially lowering the BODE score and improving prognosis. Monitor BODE longitudinally.
BODE ≥5: Consider referral for lung transplant evaluation. BODE 5–6 is a common threshold used by transplant centers. Most centers require BODE ≥7 for listing.
Pulmonary rehabilitation can improve 6MWD and mMRC grade, potentially lowering the BODE score and improving prognosis. Monitor BODE longitudinally.
For educational use only. Not a substitute for clinical judgment.
