Development of a decision tree to assess the severity and prognosis of stable COPD

作者：Esteban C^*; Arostegui I; Moraza J; Aburto M; Quintana J M; Perez Izquierdo J; Aizpiri S; Capelastegui A

来源：European Respiratory Journal, 2011, 38(6): 1294-1300.

DOI：10.1183/09031936.00189010

• Chronic obstructive pulmonary disease
• decision trees
• severity score

The aim of this study was to develop and validate a new method: a classification and regression tree (CART) based on easily accessible measures to predict mortality in patients with stable chronic obstructive pulmonary disease (COPD).
This was a prospective study of two independent prospective cohorts: a derivation cohort with 611 recruited patients and a validation cohort with 348 patients, all followed for 5 yrs. CART analysis was used to predict 5-yr mortality risk using the following covariates from the derivation cohort: age, % predicted forced expiratory volume in 1 s (FEV(1)), dyspnoea, physical activity, general health and number of hospital admissions for COPD exacerbations in the previous 2 yrs.
Age (>= 75 or <75 yrs) provided the first branch of the COPD-CART. The highest mortality risk (0.74) was seen in patients >75 yrs of age with higher levels of dyspnoea and FEV(1) <50% pred. Patients with the lowest risk of 5-yr mortality (0.04) were <55 yrs of age with FEV(1) >35% pred and one or no recent hospitalisations for COPD exacerbations.
A simple decision tree that uses variables commonly gathered by physicians can provide a quick assessment of the severity of the disease, as measured by the risk of 5-yr mortality.

• 出版日期2011-12