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Classification of Chronic Obstructive Pulmonary Disease (COPD) According to the New Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017: Comparison With GOLD 2011

Classification of Chronic Obstructive Pulmonary Disease (COPD) According to the New Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017: Comparison With GOLD 2011

Raquel Marçôa, Daniela Marta Rodrigues, Margarida Dias, Inês Ladeira, Ana Paula Vaz, Ricardo Lima, Miguel Guimarães

COPD. 2018 Feb;15(1):21-26.

PMID: 29161163

Abstract:

Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality worldwide. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) project has been working to improve awareness, prevention and management of this disease. The aim of this study is to evaluate how COPD patients are reclassified by the 2017 GOLD system (versus GOLD 2011), to calculate the level of agreement between these two classifications in allocation to categories and to compare the performance of each classification to predict future exacerbations. Two-hundred COPD patients (>40 years, post bronchodilator forced expiratory volume in one second/forced vital capacity<0.7) followed in pulmonology consultation were recruited into this prospective multicentric study. Approximately half of the patients classified as GOLD D [2011] changed to GOLD B [2017]. The extent of agreement between GOLD 2011 and GOLD 2017 was moderate (Cohen's Kappa = 0.511; p < 0.001) and the ability to predict exacerbations was similar (69.7% and 67.6%, respectively). GOLD B [2017] exacerbated 17% more than GOLD B [2011] and had a lower percent predicted post bronchodilator forced expiratory volume in one second (FEV1). GOLD B [2017] turned to be the predominant category, more heterogeneous and with a higher risk of exacerbation versus GOLD B [2011]. Physicians should be cautious in assessing the GOLD B [2017] patients. The assessment of patients should always be personalized. More studies are needed to evaluate the impact of the 2017 reclassification in predicting outcomes such as future exacerbations and mortality.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP7440575	Gold		7440-57-5	Price

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