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Characteristics and longitudinal progression of chronic obstructive pulmonary disease in GOLD B patients
- Source :
- BMC Pulmonary Medicine, Lawrence, P J, Kolsum, U, Gupta, V, Donaldson, G, Singh, R, Barker, B, George, L, Webb, A, Brookes, A J, Brightling, C, Wedzicha, J & Singh, D 2017, ' Characteristics and longitudinal progression of chronic obstructive pulmonary disease in GOLD B patients ', BMC Pulmonary Medicine, vol. 17, no. 1, 42 . https://doi.org/10.1186/s12890-017-0384-8
- Publication Year :
- 2017
- Publisher :
- Springer Science and Business Media LLC, 2017.
-
Abstract
- Background The characteristics and natural history of GOLD B COPD patients are not well described. The clinical characteristics and natural history of GOLD B patients over 1 year in a multicentre cohort of COPD patients in the COPDMAP study were assessed. We aimed to identify the subgroup of patients who progressed to GOLD D (unstable GOLD B patients) and identify characteristics associated with progression. Methods Three hundred seventy COPD patients were assessed at baseline and 12 months thereafter. Demographics, lung function, health status, 6 min walk tests and levels of systemic inflammation were assessed. Students t tests and Mann Whitney-U tests were used. Results One hundred seven (28.9%) of patients were categorised as GOLD B at baseline. These GOLD B patients had similar FEV1 to GOLD A patients (66% predicted). More GOLD B patients were current smokers (p = 0.031), had chronic bronchitis (p = 0.0003) and cardiovascular comorbidities (p = 0.019) compared to GOLD A. At 12 months, 25.3% of GOLD B patients progressed to GOLD D. These patients who progressed (unstable patients) had worse health status and symptoms (SGRQ-C Total, 50.0 v 41.1, p = 0.019 and CAT, 21.0 v 14.0, p = 0.006) and lower FEV1 (60% v 69% p = 0.014) at baseline compared to stable patients who remained in GOLD B. Conclusions Unstable GOLD B patients who progressed to GOLD D had a higher level of symptoms at baseline. A high symptom burden may predict an increased likelihood of disease progression in GOLD B patients. Electronic supplementary material The online version of this article (doi:10.1186/s12890-017-0384-8) contains supplementary material, which is available to authorized users.
- Subjects :
- Male
Pulmonary and Respiratory Medicine
Chronic bronchitis
medicine.medical_specialty
Health Status
Respiratory System
Pulmonary disease
Comorbidity
Systemic inflammation
Severity of Illness Index
VALIDATION
Pulmonary Disease, Chronic Obstructive
03 medical and health sciences
0302 clinical medicine
Forced Expiratory Volume
Internal medicine
medicine
COPD
Humans
COHORT
Prospective Studies
030212 general & internal medicine
1102 Cardiorespiratory Medicine and Haematology
Lung function
Aged
DECLINE
Science & Technology
business.industry
Disease progression
Symptom burden
STANDARDIZATION
Middle Aged
Classification
United Kingdom
Natural history
030228 respiratory system
Symptoms
Cohort
Disease Progression
Physical therapy
Female
TRAJECTORIES
medicine.symptom
business
Life Sciences & Biomedicine
LUNG
Research Article
Subjects
Details
- ISSN :
- 14712466
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- BMC Pulmonary Medicine
- Accession number :
- edsair.doi.dedup.....b9439774f08a13dfa1bb48d95b47d48f