A COPD diagnosis can feel like a death sentence was just handed out to you or your loved one. And you're not wrong to have this reaction -- after all, COPD is a progressive and terminal condition, at least eventually. But the truth is, people often live for many years with COPD and those years are often high quality too.
So, you might be wondering, what exactly will be the life expectancy after a COPD diagnosis?
First off, I just want to make the point that it is IMPOSSIBLE to predict life expectancy for anyone, whether they have COPD, cancer or any other disease, with 100% accuracy. We've all heard stories of people who overcame the most dire prognoses, as well as people who seemed perfectly healthy one day and dropped dead the next. But, that being said, healthcare professionals do have various tools they use to help them be as accurate as possible.
The BODE Index is a tool that is used to predict COPD life expectancy. It scores the person who has COPD in four different areas. Those scores are added up and a BODE score derived, which will give some estimate of life expectancy. Is it 100 percent right all the time? No, but it has been proven to provide an pretty good idea of how long COPDers might live and also to be more accurate than spirometry (FEV1) alone.
BODE Index Criteria
The four criteria, which are rated from zero up to three, are added together. The higher the total, the sooner you are likely to die from COPD. These are the criteria used in the BODE Index:
- Airway obstruction, as measured by predicted FEV1 (forced expiratory volume) via spirometry.
- Activity tolerance, as measured by the 6-minute walk test.
- Dsypnea, a measure of breathlessness related to activity.
- Body weight & build, as measured by Body Mass Index (BMI).
Let's look at each of these factors in more depth.
COPD causes a narrowing and loss of elasticity in the airways and is the underlying reason for COPD symptoms. With obstruction, it is difficult for you to breathe in the air you need to live. But in the early stages of COPD, this obstruction is often so mild you barely notice symptoms, except during intense periods of activity.
However, a test called spirometry was developed that can often pick up changes in the airways before you start noticing severe symptoms. Spirometry measures the volume and force of air as it is exhaled from your lungs. You are asked to breathe in and then to exhale forcefully into an instrument several times. The force of the air is then monitored and measured and a score, called an FEV1, is given.
The FEV1 scores correlate to BODE Index scores as follows:
- FEV1 > 64% = 0
- FEV1 50-64% = 1
- FEV1 36-49% = 2
- FEV1 < 36% = 3
Many studies exist that show that the FEV1 is a good predictor of COPD life expectancy all by itself. But recent studies suggest that using it along with the next three factors is even more accurate.