Mortality prediction in chronic obstructive pulmonary disease comparing the GOLD 2007 and 2011 staging systems: a pooled analysis of individual patient data

Soriano, Joan B.; Lamprecht, Bernd; Ramírez, Ana S.; Martínez‐Camblor, Pablo; Kaiser, Bernhard; Alfageme, Inmaculada; Almagro, Pere; Casanova, Ciro; Esteban, Cristóbal; Soler-Cataluña, Juan José; de-Torres, Juan P.; Miravitlles, Marc; Celli, Bartolomé R.; Marín, J.; Puhan, Milo A.; Sobradillo, Patricia; Lange, Peter; Sternberg, Alice L.; Garcia‐Aymerich, Judith; Turner, Alice; Han, Mei Lan K.; Langhammer, Arnulf; Leivseth, Linda; Bakke, Per; Johannessen, Ane; Roche, N.; Sin, Don D.

doi:10.1016/s2213-2600(15)00157-5

Cited by 140 publications

(136 citation statements)

References 34 publications

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“…Bronchodilator reversibility was defined as at least 12% and 200-ml increase in FEV 1 or FVC post-bronchodilator (23). COPD severity was assessed using spirometry criteria outlined by the GOLD guidelines with reference values from the National Health and Nutrition Examination Survey III (24,25). GOLD stage 0 refers to current and former smokers without COPD, which although not included in the current GOLD guidelines, was used previously (26).…”

Section: Study Population and Assessmentsmentioning

confidence: 99%

Acute Exacerbations and Lung Function Loss in Smokers with and without Chronic Obstructive Pulmonary Disease

Dransfield

Kunisaki

Strand

et al. 2017

Am J Respir Crit Care Med

266

219

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Rationale: Acute exacerbations of chronic obstructive pulmonary disease (COPD) increase the risk of death and drive healthcare costs, but whether they accelerate loss of lung function remains controversial. Whether exacerbations in subjects with mild COPD or similar acute respiratory events in smokers without airflow obstruction affect lung function decline is unknown.Objectives: To determine the association between acute exacerbations of COPD (and acute respiratory events in smokers without COPD) and the change in lung function over 5 years of follow-up.Methods: We examined data on the first 2,000 subjects who returned for a second COPDGene visit 5 years after enrollment. Baseline data included demographics, smoking history, and computed tomography emphysema. We defined exacerbations (and acute respiratory events in those without established COPD) as acute respiratory symptoms requiring either antibiotics or systemic steroids, and severe events by the need for hospitalization. Throughout the 5-year follow-up period, we collected self-reported acute respiratory event data at 6-month intervals. We used linear mixed models to fit FEV 1 decline based on reported exacerbations or acute respiratory events. Measurements and Main Results:In subjects with COPD, exacerbations were associated with excess FEV 1 decline, with the greatest effect in Global Initiative for Chronic Obstructive Lung Disease stage 1, where each exacerbation was associated with an additional 23 ml/yr decline (95% confidence interval, 2-44; P = 0.03), and each severe exacerbation with an additional 87 ml/yr decline (95% confidence interval, 23-151; P = 0.008); statistically significant but smaller effects were observed in Global Initiative for Chronic Obstructive Lung Disease stage 2 and 3 subjects. In subjects without airflow obstruction, acute respiratory events were not associated with additional FEV 1 decline.Conclusions: Exacerbations are associated with accelerated lung function loss in subjects with established COPD, particularly those with mild disease. Trials are needed to test existing and novel therapies in subjects with early/mild COPD to potentially reduce the risk of progressing to more advanced lung disease.Clinical trial registered with www.clinicaltrials.gov (NCT 00608764).

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Section: Study Population and Assessmentsmentioning

confidence: 99%

Acute Exacerbations and Lung Function Loss in Smokers with and without Chronic Obstructive Pulmonary Disease

Dransfield

Kunisaki

Strand

et al. 2017

Am J Respir Crit Care Med

266

219

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“…These mortality studies have consistently shown that group A has the lowest risk, while D has the highest risk. Some studies have shown that group B patients have worse risk compared to group C 9,12,15,22 , giving a risk ordering of A (lowest) -C -B -D (highest), while for other studies the risk ordering is A -B -C -D [17][18][19]27 ; representative survival curves for these two patterns are shown in figure 3. There is evidence that groups B and D have the highest prevalence of patients with cardiovascular comorbidities 14,15 , which presumably contributes to the increased symptoms and also increased mortality risk.…”

Section: Does Combined Assessment Improve Risk Stratification?mentioning

confidence: 99%

“…Data from different COPD cohorts have been used to understand the percentage of patients falling into groups A, B, C, and D; these data are shown in table 1 9,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] . There are considerable differences between some studies, which can be attributed to many factors, including the study design and inclusion criteria, how the patients were recruited (e.g.…”

Section: The Combined Assessment Explainedmentioning

confidence: 99%

“…Soriano et al 27 performed a pooled analysis of 15,632 patients from 22 cohorts, with data from some of these individual cohorts included in other studies, as shown in table 1. The GOLD B and D patients comprised 19 and 31%, respectively, which is generally consistent with other studies in table 1 that used mMRC to grade symptoms.…”

Section: The Combined Assessment Explainedmentioning

confidence: 99%

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Management of Chronic Obstructive Pulmonary Disease: A Personalized Interpretation of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) - ABCD Recommendations

Singh¹,

Ravi²

2016

BRN

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The Global Initiative for Chronic Obstructive Lung Disease (GOLD) advocates a combined assessment of chronic obstructive pulmonary disease using lung function, symptoms, and exacerbation history to categorise patients into group A, B, C, or D. The aims of treatment are to reduce symptoms and prevent future risk, with the choice of treatment tailored according to the category. GOLD promotes an individualised approach to treatment. This review appraises the strengths and potential weaknesses of the current GOLD recommendations for combined assessment and pharmacological treatment of stable chronic obstructive pulmonary disease. There have been a number of recent publications applying the GOLD classification system to different chronic obstructive pulmonary disease populations. What can be learnt from these papers is reviewed, as well as the evidence base for the GOLD recommendations for pharmacological therapy. (BRN Rev. 2016;2:27-39)Corresponding author: Dave Singh, DSingh@meu.org.uk

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“…Moreover, the GOLD 2011 re-classification shifted the overall COPD severity distribution to more severe categories, but without clearly documented benefits on outcomes [14]. Furthermore, the ABCD classification based on airflow severity and patient-reported outcome caused some confusion: for example, group C (high risk without significant symptoms) was rather uncommon, and had similar exacerbation frequency than group B (high symptoms but low risk); on the other hand, group D (which included subjects with severe airflow limitation alone, or with history of frequent exacerbations alone, or with both risk factors) had significant heterogeneity in exacerbation rate [15,16].…”

Section: Diagnosis and Assessmentmentioning

confidence: 99%

GOLD 2017 recommendations for COPD patients: toward a more personalized approach

2017

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The Global Initiative for Chronic Obstructive Lung Disease (GOLD), an international committee of experts, has recently published its updated report on diagnosis and management of Chronic Obstructive Pulmonary Disease (COPD). Compared to the previous version, this documents has been an extensively revised: the definition has been simplified, highlighting the importance of respiratory symptoms, and disease development is further discussed, including new insights on lung development. Spirometry is still required for the diagnosis, and it is described as fundamental tool for evaluating prognosis, disease progression, and non-pharmacologic treatment. However, differently from the previous version, spirometry is no longer included in the ABCD tool (ie, a practical tool proposed to assess COPD symptom burden and guide pharmacologic treatment), which is now centered exclusively on respiratory symptoms and history of exacerbation. Subsequently, pharmacologic treatment has been shifted towards a more personalized approach, reflecting the ongoing process toward a comprehensive, patient-tailored management.

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Mortality prediction in chronic obstructive pulmonary disease comparing the GOLD 2007 and 2011 staging systems: a pooled analysis of individual patient data

Cited by 140 publications

References 34 publications

Acute Exacerbations and Lung Function Loss in Smokers with and without Chronic Obstructive Pulmonary Disease

Acute Exacerbations and Lung Function Loss in Smokers with and without Chronic Obstructive Pulmonary Disease

Management of Chronic Obstructive Pulmonary Disease: A Personalized Interpretation of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) - ABCD Recommendations

GOLD 2017 recommendations for COPD patients: toward a more personalized approach

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