Unifying Concepts

Scoring the BODE Index

The BODE is a multidimensional index designed to assess clinical risk in people with chronic obstructive pulmonary disease (COPD). It combines four important variables into a single score: (B) body mass index; (O) airflow obstruction measured by the forced expiratory volume in one second (FEV1); (D) dyspnoea measured by the modified Medical Research Council (MRC) scale; and (E) exercise capacity measured by the 6-minute walk distance (6MWD). Each component is graded and a score out of 10 is obtained, with higher scores indicating greater risk. The BODE index reflects the impact of both pulmonary and extrapulmonary factors on prognosis and survival in COPD.

BODE Score

Variable 0 1 2 3
FEV1, % predicted >/= 65 50–65 35–49 </= 35
Dyspnea: MRC 0–1 2 3 4
6MWD, meters >/= 350 250–349 150–249 </=149
BMI > 21 </= 21

FEV1 = forced expiratory volume in 1 second; MRC = Medical Research Council; 6MWD = 6-minute walk distance test; BMI = body mass index
Calculation of the BODE index. Points from each variable are added according to the threshold value measured for each one. The value ranges from 0 to a maximum of 10


Modified MRC Dyspnoea Scale

0 Breathless only with strenuous exercise
1 Short of breath when hurrying on the level or walking up a slight hill
2 Slower than most people of the same age on the level because of breathlessness or have to stop for breath when walking at my own pace on the level
3 Stop for breath after walking about 100 meters or after a few minutes at my own pace on the level
4 Too breathless to leave the house or I am breathless when dressing



  1. Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, Mendez RA, Pinto Plata V, Cabral HJ. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med. 2004 Mar 4;350(10):1005-12. [Medline]
  2. Cote CG, Celli BR. BODE index: a new tool to stage and monitor progression of chronic obstructive pulmonary disease. Pneumonol Alergol Pol. 2009;77(3):305-13. [Medline]

Created Jun 28, 2011.

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