Evidence map›Paper›PMID 31118043›Full record

Observational studyRespiratory research2019

It's more than low BMI: prevalence of cachexia and associated mortality in COPD.

Merry-Lynn N McDonald, Emiel F M Wouters, Erica Rutten, Richard Casaburi, Stephen I Rennard, David A Lomas, Marcas Bamman, Bartolome Celli, Alvar Agusti, Ruth Tal-Singer and 3 more

Open access · goldAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Respiratory research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 2 pooled it
7.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 2 syntheses or guidelines pooled it, 100 citations in OpenAlex.

  1. NT-proBNP in Different Patient Groups of COPD: A Systematic Review and Meta-Analysis.International journal of chronic obstructive pulmonary disease · 2023
    Pooled it
  2. Pooled it
  3. Article
  4. Article
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  6. Article
  7. Review
  8. Article
  9. Article
  10. The Disproportionate Burden of Cardiovascular Disease in Mild-to-Moderate COPD.International journal of chronic obstructive pulmonary disease · 2026
    Article
  11. Article
  12. Article
  13. Article
  14. Effect of Common Medications on Longitudinal Pectoralis Muscle Area in Smokers.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2025
    Article
  15. Article
  16. Article
  17. Article
  18. Genetically Predicted Body Mass Index and Mortality in Chronic Obstructive Pulmonary Disease.American journal of respiratory and critical care medicine · 2024
    Article
  19. Dynamic and prognostic proteomic associations with FEVmedRxiv : the preprint server for health sciences · 2024
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 4 countries.

Merry-Lynn N McDonaldDivision of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. mmcdonald@uab.edu.ORCID http://orcid.org/0000-0002-2647-9422
Emiel F M WoutersCentre of expertise for chronic organ failure, Horn, the Netherlands and Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.
Erica RuttenCentre of expertise for chronic organ failure, Horn, the Netherlands and Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.
Richard CasaburiRehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor Harbor-UCLA Medical Center, Torrance, CA, USA.
Stephen I RennardDepartment of Medicine, Nebraska Medical Center, Omaha, NE, USA.
David A LomasUCL Respiratory, University College London, London, UK.
Marcas BammanCenter for Exercise Medicine and Departments of Cell, Developmental & Integrative Biology; Medicine; and Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
Bartolome CelliDivision of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA, USA.
Alvar AgustiFundació Investigació Sanitària Illes Balears (FISIB), Ciber Enfermedades Respiratorias (CIBERES), Barcelona, Catalunya, Spain.
Ruth Tal-SingerGSK R&D, Collegeville, PA, USA.
Craig P HershDivision of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA, USA.
Mark DransfieldDivision of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Edwin K SilvermanDivision of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA, USA.
Brigham and Women's Hospital · USUniversity of Alabama at Birmingham · USMaastricht University · NLCentro de Investigación Biomédica en Red de Enfermedades Respiratorias · ESGlaxoSmithKline (United States) · USNebraska Medical Center · USThe Lundquist Institute · USUniversity College London · GB

Funding

Network Medicine Approaches to Cachexia in COPDR00HL121087 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI MCDONALD DONNELLY, MERRY-LYNN NOELLE · 2017 to 2019
$747k
UAB Mentoring Program in COPD Patient Oriented ResearchK24HL140108 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI DRANSFIELD, MARK T · 2018 to 2022
$439k
Medical Research Council MR/N024842/1NHLBI NIH HHS K24 HL140108NHLBI NIH HHS R00 HL121087NHLBI NIH HHS R00HL121087Parker B. Francis Foundation Fellowship
6 · The paper itself

Abstract

backgroundCachexia is associated with increased mortality risk among chronic obstructive pulmonary disease (COPD) patients. However, low body mass index (BMI) as opposed to cachexia is often used, particularly when calculating the BODE (BMI, Obstruction, Dyspnea and Exercise) index. For this reason, we examined mortality using a consensus definition and a weight-loss definition of cachexia among COPD cases and compared two new COPD severity indices with BODE.

methodsIn the current report, the consensus definition for cachexia incorporated weight-loss > 5% in 12-months or low BMI in addition to 3/5 of decreased muscle strength, fatigue, anorexia, low FFMI and inflammation. The weight-loss definition incorporated weight-loss > 5% or weight-loss > 2% (if low BMI) in 12-months. The low BMI component in BODE was replaced with the consensus definition to create the CODE (Consensus cachexia, Obstruction, Dyspnea and Exercise) index and the weight-loss definition to create the WODE (Weight loss, Obstruction, Dyspnea and Exercise) index. Mortality was assessed using Kaplan-Meier survival and Cox Regression. Performance of models was compared using C-statistics.

resultsAmong 1483 COPD cases, the prevalences of cachexia by the consensus and weight-loss definitions were 4.7 and 10.4%, respectively. Cachectic patients had a greater than three-fold increased mortality by either the consensus or the weight-loss definition of cachexia independent of BMI and lung function. The CODE index predicted mortality slightly more accurately than the BODE and WODE indices.

conclusionsCachexia is associated with increased mortality among COPD patients. Monitoring cachexia using weight-loss criteria is relatively simple and predictive of mortality among COPD cases who may be missed if only low BMI is used.

Indexed as

Body Mass IndexConsensusAgedCachexiaFemaleHumansMaleMiddle AgedMortalityPrevalencePulmonary Disease, Chronic ObstructiveWeight LossBMIBODECachexiaCOPDWeight loss

Identifiers

PMID31118043
PMCPMC6532157
OpenAlexW2947817076

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.