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Comparison of the 2017 and 2015 Global Initiative for Chronic Obstructive Lung Disease Reports. Impact on Grouping and Outcomes
- Source :
- American Journal of Respiratory and Critical Care Medicine. 197:463-469
- Publication Year :
- 2018
- Publisher :
- American Thoracic Society, 2018.
-
Abstract
- The Global Initiative for Chronic Obstructive Lung Disease (GOLD) document has modified the grading system directing pharmacotherapy, but how this relates to the previous one from 2015 and to comorbidities, hospitalizations, and mortality risk is unknown.The aim of this study was to evaluate the changes in the GOLD groups from 2015 to 2017 and to assess the impact on severity, comorbidities, and mortality within each group.We prospectively enrolled and followed, for a mean of 5 years, 819 patients with chronic obstructive pulmonary disease (84% male) in clinics in Spain and the United States. We determined anthropometrics, lung function (FEVCompared with 2015, the 2017 grading decreased by half the proportion of patients in groups C and D (20.5% vs. 11.2% and 24.6% vs. 12.9%; P 0.001). The distribution of Charlson also changed, whereas group D was higher than B in 2015, they become similar in the 2017 system. In 2017, the BODE index and risk of death were higher in B and D than in A and C. The mortality risk was better predicted by the 2015 than the 2017 system.Compared with 2015, the GOLD ABCD 2017 classification significantly shifts patients from grades C and D to categories A and B. The new grading system equalizes the Charlson comorbidity score in all groups and minimizes the differences in BODE between groups B and D, making the risk of death similar between them.
- Subjects :
- Pulmonary and Respiratory Medicine
medicine.medical_specialty
Internationality
Pulmonary disease
Comorbidity
Critical Care and Intensive Care Medicine
Severity of Illness Index
Pulmonary Disease, Chronic Obstructive
03 medical and health sciences
0302 clinical medicine
Pharmacotherapy
Adrenal Cortex Hormones
Internal medicine
medicine
Humans
Prospective Studies
030212 general & internal medicine
Intensive care medicine
Lung function
Aged
business.industry
Anthropometry
Exercise capacity
medicine.disease
United States
Obstructive lung disease
Anti-Bacterial Agents
Respiratory Function Tests
Hospitalization
Treatment Outcome
030228 respiratory system
Spain
Ambulatory
business
Body mass index
Subjects
Details
- ISSN :
- 15354970 and 1073449X
- Volume :
- 197
- Database :
- OpenAIRE
- Journal :
- American Journal of Respiratory and Critical Care Medicine
- Accession number :
- edsair.doi.dedup.....99a6b8da794675354b6a96cf3b48eea2