Clinical characteristics of patients with chronic obstructive pulmonary disease assessed using GOLD 2016 and GOLD 2018 classifications: a cross-sectional study in China.

Abstract

BACKGROUND:

In 2017, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) removed spirometry as a criterion for classifying GOLD risk groups (A-D, low-high risk).

METHODS:

In this cross-sectional observational study in China, we used the GOLD 2016 (spirometry included) and 2018 (spirometry eliminated) criteria for classifying GOLD risk groups to describe: the proportion of patients with chronic obstructive pulmonary disease (COPD) in each GOLD risk group; disease severity; demographics and comorbidities. Patients aged ≥40 years with a clinical COPD diagnosis for ≥1 year were included. During a single study visit, patients completed the COPD assessment test, modified Medical Research Council (mMRC) dyspnea scale assessment, and spirometry tests. Demographics, medical history, and treatment data were recorded.

RESULTS:

In total, 838 patients were included. Most patients were male (86.4%), ≥65 years old (58.6%), and current or former smokers (78.5%). By GOLD 2016, the highest proportion of patients were Group D (42.8%), followed by B (28.2%). By GOLD 2018, the highest proportion of patients were Group B (57.3%), followed by A (25.5%). A total of 296 patients (35.3%) were reclassified, either from Group C to Group A or from Group D to Group B. Overall, 36.2% of patients were receiving treatment concordant with GOLD 2016 recommendations; 34.1% were not receiving any inhaled medication.

CONCLUSIONS:

The distribution of COPD severity shifted from a high-risk category (by GOLD 2016) to a low-risk category (by GOLD 2018). The high proportion of patients not receiving maintenance medication reflects a high level of under-treatment of the disease.

• Authors: Wenhua Jian, Huiqing Zeng, Xiaoju Zhang, Chunmei Yun, Zuojun Xu, Yan Chen, Guochao Shi, Yingyu Wang, Yun Li, Jinping Zheng
• Journal: Journal of thoracic disease (J Thorac Dis) Vol. 13 Issue 10 Pg. 5701-5716 (Oct 2021) ISSN: 2072-1439 [Print] China
• PMID: 34795920 (Publication Type: Journal Article)
• Copyright: 2021 Journal of Thoracic Disease. All rights reserved.