Pre-COPD Score Predicts Incident COPD in Three Cohorts

Researchers developed a pre-COPD score using 14,506 participants from the Copenhagen General Population Study who had no airflow obstruction at baseline. The score assigned points for a smoking history of at least 10 pack-years, current smoking, respiratory symptoms, asthma and a pre-bronchodilator FEV1/FVC ratio of 0.70–0.75; pre-bronchodilator FEV1 below 80% predicted received four points. Validation was conducted in the Copenhagen City Heart Study (8,673 participants) and COPDGene (2,982 participants). Participants were followed for five to 10 years; incident COPD was defined using pre-bronchodilator spirometry.

COPD developed in 4.6% of the development cohort, 7.9% of the Copenhagen validation cohort and 12% of COPDGene. In the development cohort, 10-year incidence ranged from 1.5% in the low-risk category to 42% in the very-high-risk category. Five-year incidence in the validation cohorts ranged from 3.7% to 25% in Copenhagen and from 4.1% to 31% in COPDGene. Areas under the receiver operating characteristic curve were 0.88, 0.76 and 0.81, respectively. The score was also associated with exacerbations.

The findings support risk stratification across cohorts with different risk profiles, but the abstract does not establish how the score should guide clinical decisions or whether its use improves outcomes.