• Marjolein Brusse-Keizer, Maaike Zuur-Telgen, Job van der Palen, Paul VanderValk, Huib Kerstjens, Wim Boersma, Francesco Blasi, Konstantinos Kostikas, Branislava Milenkovic, Michael Tamm, and Daiana Stolz.
• Medical School Twente, Medisch Spectrum Twente, Enschede, The Netherlands. Electronic address: m.brusse-keizer@mst.nl.
• Respir Med. 2015 Jun 1; 109 (6): 734-42.

BackgroundCurrent multicomponent scores that predict mortality in COPD patients might underestimate the systemic component of COPD. Therefore, we evaluated the accuracy of circulating levels of proadrenomedullin (MR-proADM) alone or combined with the ADO (Age, Dyspnoea, airflow Obstruction), updated ADO or BOD (Body mass index, airflow Obstruction, Dyspnoea) index to predict all-cause mortality in stable COPD patients.MethodsThis study pooled data of 1285 patients from the COMIC and PROMISE-COPD study.ResultsPatients with high MR-proADM levels (≥0.87 nmol/l) had a 2.1 fold higher risk of dying than those with lower levels (p < 0.001). Based on the C-statistic, the ADOA index (ADO plus MR-proADM) (C = 0.72) was the most accurate predictor followed by the BODA (BOD plus MR-proADM) (C = 0.71) and the updated ADOA index (updated ADO plus MR-proADM) (C = 0.70). Adding MR-proADM to ADO and BOD was superior in forecasting 1- and 2-year mortality. The net percentages of persons with events correctly reclassified (NRI+) within respectively 1-year and 2-year was 31% and 20% for ADO, 31% and 20% for updated ADO and 25% and 19% for BOD. The net percentages of persons without events correctly reclassified (NRI-) within respectively 1-year and 2-year was 26% and 27% for ADO, 27% and 28% for updated ADO and 34% and 34% for BOD.ConclusionsAdding MR-proADM increased the predictive power of BOD, ADO and updated ADO index.Copyright © 2015 Elsevier Ltd. All rights reserved.

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