Laboratory-based Intermountain Validated Exacerbation (LIVE) Score stability in patients with chronic obstructive pulmonary disease
Background The Laboratory-based Intermountain Validated Exacerbation (LIVE) Score is associated with mortality and chronic obstructive pulmonary disease (COPD) exacerbation risk across multiple health systems. However, whether the LIVE Score and its associated risk is a stable patient characteristic...
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| Language: | English |
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open Respiratory Research |
| Online Access: | https://bmjopenrespres.bmj.com/content/7/1/e000450.full |
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| author | Mehrdad Arjomandi Siyang Zeng Richard A Mularski Denitza P Blagev Dave S Collingridge Susan Rea Kyle A Carey Valerie G Press |
| author_facet | Mehrdad Arjomandi Siyang Zeng Richard A Mularski Denitza P Blagev Dave S Collingridge Susan Rea Kyle A Carey Valerie G Press |
| author_sort | Mehrdad Arjomandi |
| collection | DOAJ |
| description | Background The Laboratory-based Intermountain Validated Exacerbation (LIVE) Score is associated with mortality and chronic obstructive pulmonary disease (COPD) exacerbation risk across multiple health systems. However, whether the LIVE Score and its associated risk is a stable patient characteristic is unknown.Methods We validated the LIVE Score in a fourth health system. Then we determined the LIVE Score stability in a retrospective cohort of 98 766 patients with COPD in four health systems where it was previously validated. We assessed whether LIVE Scores changed or remained the same over time. Stability was defined as a majority of surviving patients having the same LIVE Score 4 years later.Results The LIVE Score separated patients into three LIVE Score risk groups of low, medium, and high mortality and LIVE Score stability. Mortality ranged from 6.2% for low-risk LIVE to 45.8% for high-risk LIVE (p<0.001). We found that low-risk LIVE groups were stable and high-risk LIVE groups were unstable. Low-risk LIVE group patients remained low risk, but few high-risk LIVE group patients remained high risk (79.0% high vs 48.1% medium vs 8.8% low, p<0.001 for all pairwise comparisons).Conclusion The LIVE Score identifies three major clinically actionable cohorts: a stable low-risk LIVE group, an unstable high-risk LIVE group with high mortality rates, and a medium-risk LIVE group. These observations further our understanding of how existing data used to calculate the LIVE Score may target interventions across risk cohorts of patients with COPD in a health system. |
| format | Article |
| id | doaj-art-e4ca6ef91ea74ee3bcfb8c875e7713f7 |
| institution | OA Journals |
| issn | 2052-4439 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Respiratory Research |
| spelling | doaj-art-e4ca6ef91ea74ee3bcfb8c875e7713f72025-08-20T02:22:25ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392020-09-017110.1136/bmjresp-2019-000450Laboratory-based Intermountain Validated Exacerbation (LIVE) Score stability in patients with chronic obstructive pulmonary diseaseMehrdad Arjomandi0Siyang Zeng1Richard A Mularski2Denitza P Blagev3Dave S Collingridge4Susan Rea5Kyle A Carey6Valerie G Press7Medicine, San Francisco Veterans Affairs Medical Center, San Francisco, California, USAMedicine, University of California San Francisco, San Francisco, California, USADepartment of Pulmonary & Critical Care Medicine, Northwest Permanente, Portland, Oregon, USAPulmonary and Critical Care Medicine, Intermountain Medical Center, Murray, Utah, USAPulmonary and Critical Care Medicine, Intermountain Medical Center, Murray, Utah, USACare Transformation Information Systems, Intermountain Healthcare, Salt Lake City, UT, USASection of Pulmonary and Critical Care Medicine, Department of Medicine, University of Chicago Medical Center, Chicago, Illinois, USAMedicine, University of Chicago, Chicago, Illinois, USABackground The Laboratory-based Intermountain Validated Exacerbation (LIVE) Score is associated with mortality and chronic obstructive pulmonary disease (COPD) exacerbation risk across multiple health systems. However, whether the LIVE Score and its associated risk is a stable patient characteristic is unknown.Methods We validated the LIVE Score in a fourth health system. Then we determined the LIVE Score stability in a retrospective cohort of 98 766 patients with COPD in four health systems where it was previously validated. We assessed whether LIVE Scores changed or remained the same over time. Stability was defined as a majority of surviving patients having the same LIVE Score 4 years later.Results The LIVE Score separated patients into three LIVE Score risk groups of low, medium, and high mortality and LIVE Score stability. Mortality ranged from 6.2% for low-risk LIVE to 45.8% for high-risk LIVE (p<0.001). We found that low-risk LIVE groups were stable and high-risk LIVE groups were unstable. Low-risk LIVE group patients remained low risk, but few high-risk LIVE group patients remained high risk (79.0% high vs 48.1% medium vs 8.8% low, p<0.001 for all pairwise comparisons).Conclusion The LIVE Score identifies three major clinically actionable cohorts: a stable low-risk LIVE group, an unstable high-risk LIVE group with high mortality rates, and a medium-risk LIVE group. These observations further our understanding of how existing data used to calculate the LIVE Score may target interventions across risk cohorts of patients with COPD in a health system.https://bmjopenrespres.bmj.com/content/7/1/e000450.full |
| spellingShingle | Mehrdad Arjomandi Siyang Zeng Richard A Mularski Denitza P Blagev Dave S Collingridge Susan Rea Kyle A Carey Valerie G Press Laboratory-based Intermountain Validated Exacerbation (LIVE) Score stability in patients with chronic obstructive pulmonary disease BMJ Open Respiratory Research |
| title | Laboratory-based Intermountain Validated Exacerbation (LIVE) Score stability in patients with chronic obstructive pulmonary disease |
| title_full | Laboratory-based Intermountain Validated Exacerbation (LIVE) Score stability in patients with chronic obstructive pulmonary disease |
| title_fullStr | Laboratory-based Intermountain Validated Exacerbation (LIVE) Score stability in patients with chronic obstructive pulmonary disease |
| title_full_unstemmed | Laboratory-based Intermountain Validated Exacerbation (LIVE) Score stability in patients with chronic obstructive pulmonary disease |
| title_short | Laboratory-based Intermountain Validated Exacerbation (LIVE) Score stability in patients with chronic obstructive pulmonary disease |
| title_sort | laboratory based intermountain validated exacerbation live score stability in patients with chronic obstructive pulmonary disease |
| url | https://bmjopenrespres.bmj.com/content/7/1/e000450.full |
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