Introduction: COPD is a major cause of mortality and the unpredictable trajectory of the disease can bring challenges to end of life care. We aimed to investigate known prognostic variables and scores which predict prognosis in COPD in a systematic literature review, specifically including variables that contribute to risk assessment of patients for death within 12 months.
Methods: We conducted a systematic review on prognostic variables, multivariate score or models for COPD. Ovid MEDLINE, EMBASE, the Cochrane database, Cochrane CENTRAL, DARE and CINAHL were searched up to 1st May 2016.
Results: 5276 abstracts were screened, leading to 516 full text reviews, and ten met the inclusion criteria. No multivariable indices were developed with the specific aim of predicting all-cause mortality in stable COPD within 12 months. Only 9 indices were identified that had been validated for this time period, identified from 4 studies. Tools developed using expert knowledge were also identified including: the Gold Standard Framework Prognosis Indicator Guidance, the Radbound Indicators of Palliative Care need, the Supportive and Palliative Care Indicators Tool, and the Necesidades Paliativas Programme tool.
Conclusion: A number of variables contributing to prediction of all-cause mortality in COPD were identified. However, there are very few studies which are designed to asses, or which report, the prediction of mortality at or less than 12 months. The quality of evidence remains low, such that no single variable or multivariable score can currently be recommended.