Medical College of Wisconsin
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External Validation of the COmorbidity Test. COPD 2017 Oct;14(5):513-517



Pubmed ID





The COmorbidity TEst (COTE) is a Chronic Obstructive Pulmonary Disease (COPD)-specific co-morbidity score created to predict mortality. Before its wide application at the University of New Mexico we intended to validate it. The study was conducted at the University of New Mexico Hospital (UNMH) in Albuquerque, NM, USA, a tertiary academic hospital. Consecutive patients with the clinical diagnosis of COPD were identified using the hospital's medical records system and included if they were older than 40 years, had smoked at least 20 pack-years and their post bronchodilator forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) was <0.7 without an alternative diagnosis. The data collected included demographics, co-morbidities as described in the COTE, COPD-specific therapies, spirometry results and mortality. Of 317 patients 51.4% were male, average age was 65.6 ± 9.6 years and the mean post-bronchodilator FEV1 percent predicted (FEV1%) was 52.9 ± 16.9%. 31 (9.8%) patients were on triple long-acting bronchodilator inhaler therapy, 88 (27.8%) on two long-acting bronchodilators and 163 (51.4%) on at least one long-acting bronchodilator. The median follow-up was 3.5 years (IQR = 1.9-6.9). Fifty four patients died by the end of the follow-up period and their median COTE of 4 (IQR = 1-8) was significantly higher than for the survivors with COTE = 1 (IQR = 0-6; p = 0.002). In univariable analyses COTE was positively associated while FEV1%, body mass index (BMI) and gender were negatively associated with all-cause mortality. In multivariable analysis BMI, FEV1% and COTE remained independent predictors for mortality. The COTE is an independent predictor of mortality for COPD patients at UNMH.

Author List

Villalobos N, Davidson R, Ghori UK, Abdou Y, Abukhalaf J, Guillamet RV


Uzair K. Ghori MD Assistant Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Area Under Curve
Body Mass Index
Bronchodilator Agents
Drug Therapy, Combination
Follow-Up Studies
Forced Expiratory Volume
Kaplan-Meier Estimate
Middle Aged
Pulmonary Disease, Chronic Obstructive
ROC Curve
Retrospective Studies
Sex Factors
Vital Capacity
jenkins-FCD Prod-480 9a4deaf152b0b06dd18151814fff2e18f6c05280