Abstract |
Since the publication of the new Global Initiative for Chronic Obstructive Lung Disease ( GOLD) proposal for the assessment of chronic obstructive lung disease ( COPD), four studies have used existing cohorts to explore the characteristics, temporal variability and/or relationship with outcomes of the four resulting patient categories (A, B, C and D). Here, we compare their results and address a number of frequently asked questions (FAQs) on the topic. The most salient findings were that: 1) the prevalence of these four groups depends on the specific population studied, C being the least prevalent; 2) comorbidities are particularly prevalent in the two "high-symptom" groups (B and D); 3) patients classifiedZ as A or D tend to remain in the same group over time, whereas those classified as B or C change substantially during follow-up; 4) mortality at 3 years was lowest in A and worst in D but surprisingly similar (and intermediate) in B and C; and 5) the incidence of exacerbations during follow-up increases progressively from A to D but that of hospitalisations behave similarly to mortality. These results identify several strengths and shortcomings of the new GOLD assessment proposal, particularly that group B is associated with more morbidity and high mortality.
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Authors | Alvar Agusti, Suzanne Hurd, Paul Jones, Leonardo M Fabbri, Fernando Martinez, Claus Vogelmeier, Jørgen Vestbo, Robert Rodriguez-Roisin |
Journal | The European respiratory journal
(Eur Respir J)
Vol. 42
Issue 5
Pg. 1391-401
(Nov 2013)
ISSN: 1399-3003 [Electronic] England |
PMID | 23645406
(Publication Type: Comparative Study, Journal Article, Review)
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Topics |
- Aged
- Cohort Studies
- Disease Progression
- Female
- Forced Expiratory Volume
- Hospitalization
- Humans
- Male
- Middle Aged
- Prevalence
- Pulmonary Disease, Chronic Obstructive
(diagnosis, mortality, physiopathology, therapy)
- Pulmonary Medicine
(standards)
- Severity of Illness Index
- Survival Analysis
- Time Factors
- Treatment Outcome
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