Tuberc Respir Dis.  2018 Oct;81(4):281-288. 10.4046/trd.2017.0114.

The Comparison of Clinical Variables in Two Classifications: GOLD 2017 Combined Assessment and Spirometric Stage of Chronic Obstructive Pulmonary Disease

• Candemir I
• Ergun P
• Kaymaz D
• Tasdemir F
• Egesel N

• KMID: 2420561
• DOI: http://doi.org/10.4046/trd.2017.0114

Abstract

BACKGROUND
There are limited number of studies that investigate clinical variables instead of chronic obstructive lung disease (COPD) management according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 classification. The aim of the study was to investigate whether there was a difference between GOLD 2017 classification and spirometric stage in clinical variables in patients with COPD. The data of 427 male patients with stable COPD were investigated retrospectively.
METHODS
Patients were allocated into combined assessment of GOLD 2017 and spirometric stage. Age, amount of smoking, pulmonary function, modified Medical Research Council (mMRC), incremental shuttle walk test (ISWT), Hospital Anxiety-Depression Scale (HADS), St. George's Respiratory Questionnaire (SGRQ), body mass index (BMI), and fat free mass index (FFMI) were recorded.
RESULTS
Seventy-three (17%) patients were in group A, 103 (24%) constituted group B, 38 (9%) were included in group C, and 213 (50%) comprised group D according to the combined assessment of GOLD 2017. Twenty-three patients (5%) were in stage 1, 95 (22%) were in stage 2, 149 (35%) were in stage 3, and 160 (38%) were in stage 4 according to spirometric stage. According to GOLD 2017, age, amount of smoking, mMRC, BMI, FFMI, SGRQ, HADS, forced vital capacity, forced expiratory volume in 1 second (FEV1), and ISWT were significantly different between groups. Ages, amount of smoking, FFMI, BMI, HADS of group A were different from B and D. Smiliar values of FEV1 were found in A-C and B-D. A and C had smiliar ISWT. According to spirometric stage, BMI, FFMI of stage 4 were statistically different. mMRC, ISWT, and SGRQ of stages 3 and 4 were different from other stages, amongst themselves. FEV1 was correlated with mMRC, SGRQ, anxiety scores, BMI, FFMI, and ISWT.
CONCLUSION
This study showed that the GOLD ABCD classification might not represent the severity of COPD sufficiently well in terms of lung function or exercise capacity. The combination of both spirometric stage and combined assessment of GOLD 2017 is important, especially for estimating clinical variables.

Keyword

Pulmonary Disease, Chronic Obstructive; Quality of Life; Dyspnea

MeSH Terms

Anxiety
Body Mass Index
Classification*
Dyspnea
Forced Expiratory Volume
Humans
Lung
Male
Pulmonary Disease, Chronic Obstructive*
Quality of Life
Retrospective Studies
Smoke
Smoking
Vital Capacity
Smoke

Figure

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  Figure 1 Statistically different parameters between the groups according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017. BMI: body mass index; FFMI: fat-free mass index; ISWT: incremental shuttle walk test distance; SGRQ: St. George's Respiratory Questionnaire.

• 

  Figure 2 Statistically different parameters between the groups according to spirometric stage. BMI: body mass index; FFMI: fat-free mass index; mMRC, modified Medical Research Council; ISWT: incremental shuttle walk test distance; SGRQ: St. George's Respiratory Questionnaire.

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