Which GOLD B patients progress to GOLD D with the new classification?
- Abstract
- BACKGROUND: The 2017 GOLD guidelines revised assessment of COPD by eliminating the FEV(1) criterion. AIM: First, we explored the redistribution of 2011 GOLD groups by reference to the 2017 GOLD criteria. Second, we investigated the characteristics of GOLD B patients and the natural course of GOLD B patients according to the 2017 GOLD guidelines. METHODS: In total, 2,010 COPD patients in the Korean COPD Subgroup Study cohort were analyzed at baseline and 1 year after enrollment. RESULTS: The 2011 GOLD C patients were redistributed to the 2017 A (64.5%) and C (35.4%) groups. The 2011 GOLD D patients were redistributed to the 2017 B (61.6%) and D (38.6%) groups. The GOLD B patients constituted 62.7% of all patients according to the 2017 classification. Such patients exhibited higher % predicted FEV(1) values, longer six-minute walk distances, fewer symptoms, and lower inflammatory marker levels than GOLD D patients. Most GOLD B patients remained in that group (69.1%), but 13.8% progressed to group D at 1-year follow-up. The factors associated with progression from GOLD B to GOLD D were older age, higher modified Medical Research Council (mMRC) and St George's Respiratory Questionnaire (SGRQ) symptom scores, and a lower % predicted FEV(1) value. CONCLUSION: Severe symptoms, poorer health status, and greater airflow limitation increased patients' risk of exacerbation and progression from group B to group D when the 2017 GOLD criteria were applied.
- All Author(s)
- H. S. Choi
; J. O. Na
; J. D. Lee
; K. C. Shin
; C. K. Rhee
; Y. I. Hwang
; S. Y. Lim
; K. H. Yoo
; K. S. Jung
; Y. B. Park
- Issued Date
- 2018
- Type
- Article
- Keyword
- COPD; GOLD B; progression
- Publisher
- DOVE Medical Press
- ISSN
- 1176-9106
; 1178-2005
- Citation Title
- International journal of chronic obstructive pulmonary disease
- Citation Volume
- 13
- Citation Start Page
- 3233
- Citation End Page
- 3241
- Language(ISO)
- eng
- DOI
- 10.2147/copd.S177944
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/831
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