R build status CRAN Status Project Status: Active – The project has reached a stable, usable state and is being actively developed.


R package for the CODEX (comorbidity, obstruction, dyspnea, and previous severe exacerbations) index: Short and Medium-term (3 to 12 months) Prognosis in Patients Hospitalized for COPD Exacerbations described in https://www.sciencedirect.com/science/article/pii/S0012369215345888.


You can download the latest development version from GitHub:



To get CODEX index, you will need to pass in patient’s risk factors. For example:

codex (age = 40,charlson = 8 , FEV1 = 40, mMRC = 3, exacerbation = 2)

The codex() function returns a CODEX index with possible values range from 0 to 10, with higher scores indicating a greater risk of death. It was a successful predictor of survival and readmission at 3 months and 1 year after hospital discharge for a COPD exacerbation.

Cloud-based API Access

The PRISM platform allows users to access CODEXindex through the cloud. A MACRO-enabled Excel-file can be used to interact with the model and see the results. To download the PRISM Excel template file for CODEXindex please refer to the PRISM model repository.


Please cite:

Almagro, P., Soriano, J. B., Cabrera, F. J., Boixeda, R., Alonso-Ortiz, M. B., Barreiro, B., ... & Heredia, J. L. (2014). Short-and medium-term prognosis in patients hospitalized for COPD exacerbation: the CODEX index. Chest, 145(5), 972-980.