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BODE Index for COPD Survival

The BODE Index predicts a chronic obstructive pulmonary disease patient's risk for mortality. This incorporates forced expiratory volume, walking distance in 6 minutes, dyspnea severity, and body mass index.
Forced Expiratory Volume1 (% of predicted)
>=65% 0
50-64% 1
36-49% 2
<35% 3
>=350 m (383 yds) 0
250-349 m (273-382 yds) 1
150-249 m (164-272 yds) 2
<=149 m (163 yds) 3
Dyspnea only with tough workout 0
Dyspnea when walking or hurrying up a small hill 0
Walks slower than people of similar age because of dyspnea or stand for breath when walking at own pace 1
Stands for breath after walking 100 yards (91 m) or after a few minutes 2
Too dyspneic to leave the house or breathless while dressing 3
>21 0
<=21 1


Measured Factor
BODE Index
Measured Factor Disease
  • Mortality from COPD
Measured Factor Detail
The BODE Index predicts a patient with chronic obstructive pulmonary diseases' (COPD) risk for mortality. The score is important as most individuals want to keep their chance for survival as high as possible. COPD results chronic inflammation in the airways and a variety of complications. Complications can include respiratory infections, heart problems, lung cancer, high blood pressure, and depression.
Body System
Measured Factor Low Impact
  • Low risk for mortality from COPD
Measured Factor High Impact
  • High risk for mortality from COPD
  • N/A

Result Interpretation

Ranges Ranges
  • Critical Low: N/A
  • Critical High: 7-10 points
  • Normal: 0-2 points
  • Normal Adult Male: 0-2 points
  • Normal Adult Female: 0-2 points
  • Normal Pediatric: N/A
  • Normal Neonate Female: N/A
  • Normal Geriatric Male: 0-2 points
  • Normal Geriatric Female: 0-2 points
Result Low Conditions
  • N/A
Result High Conditions
  • COPD
False Positive
  • Short height
  • dyspnea
  • low forced expiratory volume
  • short 6 min walk distance
  • low body mass index
References: 2
Test Limitations
References: 2


Study Validation 1
The BODE Index is used to evaluate a chronic obstructive pumonary disease (COPD) patient's survival. An individual’s body mass index, airway obstruction, dyspnea scale, and exercise capacity are used in this index. The objective of this study was to determine the relationship between the BODE Index, the components used in its calculation, disease severity, and proinflammatory biomarkers. 

This cross-sectional study included 290 patients. A BODE Index was determined for each patient. The c-reactive protein, tumor necrosis factor alpha, and interleukin 6 was measured in each patient’s serum. A significant relationship was found between the BODE Index and proinflammatory markers. The BODE Index can be used to determine COPD survival. Interleukin 6 may be a useful biomarker for determining COPD severity.
References: 3
Study Validation 2
The original BODE Index utilizes exercise capacity as one of the factors in determining chronic obstructive pulmonary disease (COPD) survival The exercise component is a 6-minute walk test. The objective of this study was to substitute the exercise capacity component of the original BODE Index with scores from the Pulmonary Functional Status and Dyspnea Questionnaire-Modified (PFSDQ-M), Human Activity Profile questionnaire, and Glittre ADL Test (TGlittre). This would create three different modified BODE Indexes. 

This study determine 4 BODE Index score (1 original, 3 modified) for 28 patients. A strong association was seen been the original BODE Index and each of the three modified BODE Indexes. The BODE TGlittre Index and the BODE PFSDQ-M Index can be used as alternatives to the original BODE Index when the required materials for the 6-minute walk test are not available or when the patient is unable to complete the 6-minute walk test.
References: 4
Study Validation 3
The original BODE Index utilizes exercise capacity as one of the factors in determining chronic obstructive pulmonary disease (COPD) severity. The exercise component is a 6-minute walk test. The objective of this study was to substitute the exercise capacity component of the original BODE Index with oxygen consumption and see the degree of association between the two. 

Fifty COPD patients received two BODE Indexes each (one from the original BODE Index, one from the modified BODE Index). A strong correlation was found between the original and modified BODE Indexes.
References: 5
Study Additional 1
The BODE Index is used to predict mortality in patients with chronic obstructive pulmonary disease (COPD). The prospective cohort study aimed to evaluate the BODE Index’s ability to predict COPD exacerbations. 

275 patients were enrolled in the study and looked at every 6 months. Clinical information and the BODE Index values for these patients were recorded. The time to an exacerbation was inversely proportional to the worsening BODE Index. The BODE Index was better at predicting exacerbations than the forced expiratory volume by itself.
References: 6
Study Additional 2
The objective of the study was to compare the BODE Index in chronic obstructive pulmonary disease (COPD) patients who had frequent and infrequent exacerbations. 76 patients were included in the 1 year-long retrospective study. 

178 exacerbations were recorded within this time. A statistically significant difference was found between the BODE Index scores associated with frequent and infrequent exacerbators. The patients with frequent exacerbations had significantly higher BODE Index scores.
References: 7
Study Additional 3
The study aimed to assess the relationship between the BODE Score and the health-related quality of life in Chinese chronic obstructive pulmonary disease (COPD) patients. 450 patients located in Beijing, China, were included in the study. St. George’s Respiratory Questionnaire was used to represent the patient’s health-related quality of life. Each patient was followed by 12 months. The BODE Index is associated to St. George’s Respiratory Questionnaire.
References: 8


Bartolome R. Celli
, MD
Harvard Medical School, Brigham and Women's Hospital
Research Interests: Professor of Medicine


  1. Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, Mendez RA, Pinto Plata V, Cabral HJ. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med. 2004 Mar 4;350(10):1005-12.
  2. N/A
  3. Khan NA, Daga MK, Ahmad I, Mawari G, Kumar S, Kumar N, Husain SA. Evaluation of BODE index and its relationship with systemic inflammation mediated by proinflammatory biomarkers in patients with COPD. J Inflamm Res. 2016 Nov 18;9:187-198.
  4. Moreira FBR, de Fuccio MB, Ribeiro-Samora GA, Velloso M. Replacement of the 6-Min Walk Test With Glittre ADL Test and Scores From the PFSDQ-M and HAP Questionnaires in the BODE Index. J Cardiopulm Rehabil Prev. 2018 May;38(3):193-197.
  5. Cardoso F, Tufanin AT, Colucci M, Nascimento O, Jardim JR. Replacement of the 6-min walk test with maximal oxygen consumption in the BODE Index applied to patients with COPD: an equivalency study. Chest. 2007 Aug;132(2):477-82.
  6. Marin JM, Carrizo SJ, Casanova C, Martinez-Camblor P, Soriano JB, Agusti AG, Celli BR. Prediction of risk of COPD exacerbations by the BODE index. Respir Med. 2009 Mar;103(3):373-8. doi: 10.1016/j.rmed.2008.10.004.
  7. Hodgev VA, Kostianev SS, Marinov BA. Correlation of frequency of exacerbations with the BODE index in COPD patients. Folia Med (Plovdiv). 2006;48(2):18-22.
  8. Lin YX, Xu WN, Liang LR, Pang BS, Nie XH, Zhang J, Wang H, Liu YX, Wang DQ, Xu ZY, Wang HW, Zhang HS, He ZY, Yang T, Wang C. The cross-sectional and longitudinal association of the BODE index with quality of life in patients with chronic obstructive pulmonary disease. Chin Med J (Engl). 2009 Dec 20;122(24):2939-44.

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