“Can Do, Do Do” Quadrants and 6-Year All-Cause Mortality in Patients With COPD

Vaes, Anouk W.; Spruit, Martijn A.; Koolen, Eleonore H.; Antons, Jeanine; Man, Marianne de; Djamin, Remco S.; Hees, Hieronymus W. H. van; Hul, Alex J van ’t

doi:10.1016/j.chest.2021.12.657

Cited by 21 publications

(28 citation statements)

References 53 publications

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“…Alongside the multidimensional instruments, new prognostic factors emerged recently, including physical capacity (PC). 18 It was found that patients with COPD with a decreased PC had a significantly higher long-term mortality risk, regardless of the level of physical activity. 18 Presumably, combining GOLD groups and PC could increase the prognostic ability, similarly to our previous work where we combined GOLD groups and arterial blood gases, clearly increasing prognostic value at least in GOLD group B.…”

Section: Discussionmentioning

confidence: 96%

“…18 It was found that patients with COPD with a decreased PC had a significantly higher long-term mortality risk, regardless of the level of physical activity. 18 Presumably, combining GOLD groups and PC could increase the prognostic ability, similarly to our previous work where we combined GOLD groups and arterial blood gases, clearly increasing prognostic value at least in GOLD group B. 17 Limitations of this study include: a potential selection bias (the CMRD cohort is composed of patients with moderateto-severe COPD with FEV 1 < 60% predicted), and a potential gender bias (the cohort included 73% of men).…”

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confidence: 96%

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Prognostic Properties of the GOLD 2023 Classification System

Brat¹,

Svoboda²,

Zatloukal³

et al. 2023

COPD

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Introduction Recently, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) has published an update on the Global Strategy for Prevention, Diagnosis and Management of COPD, introducing a new classification of chronic obstructive pulmonary disease (COPD). Our aim was to assess the prognostic value of the new GOLD classification system in comparison with the previous GOLD classification systems (GOLD stages I–IV and GOLD groups A-D) and the BODE index. Methods We used the data of 784 patients with COPD from the Czech Multicenter Research Database of COPD. Patient survival was analyzed with the use of Kaplan–Meier estimate and Cox model of proportional risks. ROC analysis and area under curve (AUC) were used for comparison of GOLD classifications and BODE index. The analyses were performed with the use of software R (version 4.2.0). Results We analyzed data of 782 patients with complete data on GOLD classifications. The study population comprised 72.9% of men, 89.1% current or former smokers, with a mean age of 66.6 years, a mean BMI of 27.4 and a mean FEV 1 44.9% of predicted. Probability of 5-year survival differed by GOLD classification. Application of the 2023 GOLD classification showed increased risk of death in group B (HR 1.82, 95% CI 1.14–2.92; p = 0.013) and in group E (HR 2.48, 95% CI 1.54–3.99; p˂0.001). The ROC analysis showed that the overall prognostic value of the 2023 GOLD classification was similarly weak to previous A-D GOLD classification schemes (AUCs 0.557–0.576) and was lower compared to the GOLD 1–4 system (AUC 0.614) and even lower when compared to the BODE index (AUC 0.715). Conclusion We concluded that the new GOLD classification system has poor prognostic properties and that specific prediction tools (eg, the BODE index) should be used for mortality risk assessment.

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Section: Discussionmentioning

confidence: 96%

mentioning

confidence: 96%

Prognostic Properties of the GOLD 2023 Classification System

Brat¹,

Svoboda²,

Zatloukal³

et al. 2023

COPD

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“…V aes et al [ 25 ] updated our understanding of the association between physical activity and mortality, investigating whether changes in physical capacity “can do” and daily physical activity “do do” influenced all-cause mortality in a cohort of 829 patients with COPD. The combination of low physical activity defined as <5000 steps per day and low physical capacity defined as 6MWT distance of <70% predicted were associated with higher mortality over 55 months.…”

Section: Group 102: Rehabilitation and Chronic Carementioning

confidence: 99%

European Respiratory Society International Congress 2021: Highlights from the Respiratory clinical care and physiology assembly

et al. 2022

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It is a challenge to keep abreast of all the clinical and scientific advances in the field of respiratory medicine. This article contains an overview of laboratory-based science, randomised controlled trials and qualitative research that were presented during the 2021 European Respiratory Society International Congress within the sessions from the five groups of the Assembly 1 – Respiratory clinical care and physiology. Selected presentations are summarised from a wide range of topics: clinical problems, rehabilitation and chronic care, general practice and primary care, electronic/mobile health (e-health/m-health), clinical respiratory physiology, exercise and functional imaging.

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“…The result is four quadrants to which a person is allocated: (1) “can do–do do” (high PC, high PA), (2) “can do–do not do” (high PC, low PA), (3) “cannot do–do do” (low PC, high PA), and (4) “Cannot do–do not do” (low PC, low PA). To date, the PC-PA quadrant concept has been applied in people with pulmonary diseases [ 3 , 4 , 5 , 6 , 7 ]. Here, the concept emerged as a promising approach to form clinically distinct groups and to contrast an individual’s ability to perform physical activities and their actual performance of PA in everyday life.…”

Section: Introductionmentioning

confidence: 99%

“Can Do” vs. “Do Do” in Older Adults: A Cross-Sectional Analysis of Sensor-Derived Physical Activity Patterns

Adams

Carrascosa

Jansen

et al. 2023

Sensors

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(1) Background: Identifying groups with a misaligned physical capacity (PC) and physical activity (PA) is potentially relevant for health promotion. Although an important health determinant, deeper knowledge of underlying walking behavior patterns in older adults is currently missing. We aim to identify specific PA signatures of misaligned groups and determine PA variables discriminating between groups. (2) Methods: In total, 294 community-dwelling older adults (≥70 years) were divided into four quadrants based on thresholds for PA (≥ or <5000 steps/day) and PC (≤ or >12 s, Timed Up and Go test). Kruskal–Wallis and effect sizes were calculated to compare quadrants’ PA variables and to determine the discriminative power of PA parameters on walking duration, frequency, and intensity. (3) Results: We identified quadrant-specific PA signatures. Compared with “can do–do do”, the “cannot do–do do” group performs shorter continuous and lower-intensity walks; the “can do–do not do” group takes fewer steps and walks with less intensity. The “cannot do–do not do” group presents lower values in all PA variables. “Walking duration greater or equal 3 METs” was the strongest discriminative PA variable. (4) Conclusion: We provide distinct PA signatures for four clinically different groups of older adults. Walking intensity is most useful to distinguish community-dwelling older adults, which is relevant for developing improved customized health promotion interventions.

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“Can Do, Do Do” Quadrants and 6-Year All-Cause Mortality in Patients With COPD

Cited by 21 publications

References 53 publications

Prognostic Properties of the GOLD 2023 Classification System

Prognostic Properties of the GOLD 2023 Classification System

European Respiratory Society International Congress 2021: Highlights from the Respiratory clinical care and physiology assembly

“Can Do” vs. “Do Do” in Older Adults: A Cross-Sectional Analysis of Sensor-Derived Physical Activity Patterns

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