Chronic Obstructive Pulmonary Disease (COPD) should be considered in individuals exposed to harmful agents to lung health, especially in people aged 40 years or older who present chronic signs and symptoms such as cough, dyspnea, fatigue with minimal exertion, and sputum production. Although a reduction in FEV1 is an important indicator, the assessment of the severity and prognosis of COPD requires additional parameters. The BODEXs90 index is a multidimensional tool that evaluates predictive variables for mortality, providing a more comprehensive assessment of the consequences of the disease.

To explore the association between COPD severity and prognosis using the BODEXs90 index.

A cross-sectional study was conducted with patients diagnosed with COPD, confirmed by spirometry with FEV1/FVC < 0.7, according to the criteria of the Global Initiative for Chronic Obstructive Lung Disease (GOLD), under follow-up in an outpatient pulmonary service. Patients aged 40 to 90 years, without cognitive or oral communication deficits, and who did not depend on oxygen supplementation, were included. To compose the domains of the prognostic index, the following were evaluated: Body Mass Index (BMI), percentage of FEV1 after bronchodilation spirometry, symptom intensity by the COPD Assessment Test (CAT), degree of dyspnea by the Modified Medical Research Council (mMRC), history of exacerbations, and baseline oxygen saturation (SpO2). The associations were determined through Pearson chi-square analysis and Fisher&apos;s exact test.

The sample consisted of 65 individuals, with an average age of 67.1 ± 8.5 years, with the majority being female (55.4%). The predominant educational level was elementary school (75.4%). More than half of the patients (56.9%) reported exacerbation events. Regarding BMI, 44.6% were of normal weight, 16.9% were underweight, 16.9% were overweight, and 21.5% had some degree of obesity. The average baseline SpO2 was 94.5 ± 2.8. Severe FEV1 reduction (GOLD 3) was more prevalent (44.6%). No significant difference was observed between the CAT classification and predominant sex in both sexes [??2(3) = 2.394; p = 0.49], nor in degree 1 of dyspnea by sex [??2(4) = 1.381; p = 0.85]. A significant association was observed between COPD severity and prognosis in the BODEXs90 index [??2(6) = 22.925; p = 0.001], indicating that patients with moderate obstruction were classified in the mild category of BODEXs90 compared to other categories.

The greater the degree of airflow obstruction, the worse the prognosis and the estimated survival at four years, regardless of sex. The use of the BODEXs90 index proved to be effective in assessing the prognosis of COPD patients.

Personalizing the treatment of COPD patients based on a multidimensional prognostic system such as the BODEXs90 index is important for adjusting therapies and also for supporting the early identification of patients at higher risk of disease progression.