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BODE Index for COPD Survival

The BODE index (0–10) predicts mortality in COPD from Body-mass index, airflow Obstruction (FEV₁ % predicted), Dyspnea (mMRC) and Exercise capacity (6-minute walk distance). Higher quartiles (0–2, 3–4, 5–6, 7–10) carry approximate 4-year survival of 80%, 67%, 57% and 18%.

FEV₁ (% predicted, post-bronchodilator) (%)
6-minute walk distance (m)
mMRC dyspnea grade: 0: breathless only with strenuous exercise (0); 1: short of breath hurrying on level or walking up a slight hill (0); 2: walks slower than peers or stops for breath at own pace (1); 3: stops for breath after ~100 m or a few minutes on level (2); 4: too breathless to leave the house or when dressing (3)
BMI

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Interpretation

Result	Meaning
0–2	~80% 4-year survival
3–4	~67%
5–6	~57%
7–10	~18%

Formula

FEV₁ %pred: ≥65 0, 50–64 1, 36–49 2, ≤35 3 · 6MWD (m): ≥350 0, 250–349 1, 150–249 2, ≤149 3 · mMRC: 0–1 0, 2 1, 3 2, 4 3 · BMI: >21 0, ≤21 1

Clinical pearls

Use post-bronchodilator FEV₁ in clinically stable patients.
A BODE ≥7 is one of the criteria used to consider referral for lung transplantation (BODE 5–6 for referral, 7–10 for listing in older ISHLT guidance).

Examples

bode fev1 40% 6mwd 300 m mmrc 3 bmi 20 BODE index for COPD with FEV1 70 percent predicted, walks 400 meters, mMRC 1, BMI 25

FAQ

What does a high BODE index mean?

Higher BODE scores predict higher mortality; a score of 7–10 is associated with roughly 18% survival at 4 years in the derivation cohort.

Why is BODE better than FEV₁ alone?

It captures systemic effects of COPD (nutrition, dyspnea, exercise capacity) and predicted death better than FEV₁ (C statistic 0.74 vs 0.65).

Evidence

Celli BR et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 2004;350:1005–12.

Pulmonary & Critical Care · Reviewed 2026-10-14 · Methodology