Background: Incidence of chronic obstructive pulmonary disease (COPD) acute exacerbation of increases in pilgrims during hajj period. Early diagnosis and grading of COPD before hajj is important to start treatment and reduce risk of acute exacerbation. Body Mass, Obstruction, Dyspnea, Exercise (BODE) Index is a multidimensional grading system to predict risk of COPD acute exacerbation.
Objective: To find association between BODE Index and incidence of COPD acute exacerbation in hajj pilgrims.
Methods: This is a retrospective cohort study among hajj pilgrims from Jakarta in 2012 who were known to have COPD. BODE index was calculated from medical records which had been obtained from health screening 24 hours before flight. Exacerbation was determined immediately after arrival home through history taking and examination of subject, interview with the physician in-charge of each flight group, and analysis of personal hajj book. Association between two variables and relative r isk were calculated using Chi-Square test or Fisher Exact test. Results: Sixty COPD subjects with complete BODE index data were identified and recruited. Thirty five subjects (58.3%) suffered from acute exacerbation of COPD, 5 (14.2%) of which were hospitalized. In BODE index range from 0-6, 48 subjects (80%) had 0-2, 6 subjects (10%) had 3-4, and 6 subjects (10%) had 5-6. The result of Chi-Square and Fisher Exact test between low risk group (BODE index 0-3) and high risk group (BODE index >3) is p=0.01 and relative risk 1.9 (CI95% 1.4-2.5).
Conclusion: There is an association between BODE Index and acute exacerbation of COPD among hajj pilgrims from Jakarta in 2012. The range of BODE index was 0-6. Hajj pilgrims with BODE index of >3 had significantly higher risk of acute exacerbation of COPD compared to pilgrims with BODE index of 0-3.
Keywords: BODE, hajj, pilgrims, acute exacerbation of COPD.