New GOLD classification: Longitudinal data on group assignment

Casanova, C. ; Marin, J. M. (Universidad de Zaragoza) ; Martinez-Gonzalez, C. ; de Lucas-Ramos, P. ; Mir-Viladrich, I. ; Cosio, B. ; Peces-Barba, G. ; Calle-Rubio, M. ; Solanes-García, I. ; Agüero, R. ; de Diego-Damia, A. ; Feu-Collado, N. ; Alfageme, I. ; Irigaray, R. ; Balcells, E. ; Llunell, A. ; Galdiz, J. B. ; Marín, M. ; Soler-Cataluña, J. J. ; Lopez-Campos, J. ; Soriano, J. B. ; de-Torres, J. ; de Lucas, P. ; Marín, J. M. ; Soler Cataluña, J. J. ; Bonachera, J. C. ; Bautista, C. L. ; Domenech, A. ; Michavila, I. A. ; Marín Trigo, J. M. ; González, C. M. ; Piqueras, B. G. -C ; López, C. C. ; Acosta, A. S. ; Macario, C. C. ; González, J. A. ; Balbin, R. A. ; Campos, E. M. ; Marin, A. ; Moreno, A. ; Márquez Pérez, F. L. ; Riesco Miranda, J. A. ; Rodríguez, J. T. ; Gómez, R. G. ; Romero, G. P. -B ; de, Miguel D. ; Río, F. G. ; Lobato, S. D.

Resumen: Rationale:
Little is known about the longitudinal changes associated with using the 2013 update of the multidimensional GOLD strategy for chronic obstructive pulmonary disease (COPD).
Objective:
To determine the COPD patient distribution of the new GOLD proposal and evaluate how this classification changes over one year compared with the previous GOLD staging based on spirometry only.
Methods:
We analyzed data from the CHAIN study, a multicenter observational Spanish cohort of COPD patients who are monitored annually. Categories were defined according to the proposed GOLD: FEV1%, mMRC dyspnea, COPD Assessment Test (CAT), Clinical COPD Questionnaire (CCQ), and exacerbations-hospitalizations. One-year follow-up information was available for all variables except CCQ data.
Results:
At baseline, 828 stable COPD patients were evaluated. On the basis of mMRC dyspnea versus CAT, the patients were distributed as follows: 38.2% vs. 27.2% in group A, 17.6% vs. 28.3% in group B, 15.8% vs. 12.9% in group C, and 28.4% vs. 31.6% in group D. Information was available for 526 patients at one year: 64.2% of patients remained in the same group but groups C and D show different degrees of variability. The annual progression by group was mainly associated with one-year changes in CAT scores (RR, 1.138; 95%CI: 1.074-1.206) and BODE index values (RR, 2.012; 95%CI: 1.487-2.722).
Conclusions:
In the new GOLD grading classification, the type of tool used to determine the level of symptoms can substantially alter the group assignment. A change in category after one year was associated with longitudinal changes in the CAT and BODE index.

Idioma: Inglés

DOI: 10.1186/1465-9921-15-3

Año: 2014

Publicado en: RESPIRATORY RESEARCH 15, 3 (2014), [9 pp]
ISSN: 1465-9921

Factor impacto JCR: 3.093 (2014)

Categ. JCR: RESPIRATORY SYSTEM rank: 18 / 57 = 0.316 (2014) - Q2 - T1

Tipo y forma: Article (Published version)

Área (Departamento): Medicina (Departamento de Medicina, Psiquiatría y Dermatología)