RATIONALE: The new Global Initiative for Obstructive Lung Disease (GOLD) stratification of chronic obstructive pulmonary disease (COPD) into categories A, B, C, and D is based on symptoms, level of lung function, and history of exacerbations. OBJECTIVES: To investigate the abilities of this stratification to predict the clinical course of COPD. METHODS: Two similar population studies were performed in an area of Copenhagen including 6,628 individuals with COPD. MEASUREMENTS AND MAIN RESULTS: The patients were monitored for an average period of 4.3 years regarding COPD exacerbations, hospital admissions, and mortality. The percentages of individuals experiencing a COPD exacerbation during the first year of observation were 2.2% in group A, 5.8% in group B, 25.1% in group C, and 28.6% in group D. One- and 3-year mortality rates were 0.6 and 3.8%, respectively, in group A, 3.0 and 10.6% in group B, 0.7 and 8.2% in group C, and 3.4 and 20.1% in group D. Groups B and D, characterized by a higher degree of dyspnea than groups A and C, had five to eight times higher mortality from cardiovascular disease and cancer than did groups A and C. CONCLUSIONS: The new stratification performs well by identifying individuals at risk of exacerbations. Surprisingly, subgroup B, characterized by more severe dyspnea, had significantly poorer survival than group C, in spite of a higher FEV(1) level. This subgroup warrants special attention, as the poor prognosis could be caused by cardiovascular disease or cancer, requiring additional assessment and treatment.
RATIONALE: The new Global Initiative for Obstructive Lung Disease (GOLD) stratification of chronic obstructive pulmonary disease (COPD) into categories A, B, C, and D is based on symptoms, level of lung function, and history of exacerbations. OBJECTIVES: To investigate the abilities of this stratification to predict the clinical course of COPD. METHODS: Two similar population studies were performed in an area of Copenhagen including 6,628 individuals with COPD. MEASUREMENTS AND MAIN RESULTS: The patients were monitored for an average period of 4.3 years regarding COPD exacerbations, hospital admissions, and mortality. The percentages of individuals experiencing a COPD exacerbation during the first year of observation were 2.2% in group A, 5.8% in group B, 25.1% in group C, and 28.6% in group D. One- and 3-year mortality rates were 0.6 and 3.8%, respectively, in group A, 3.0 and 10.6% in group B, 0.7 and 8.2% in group C, and 3.4 and 20.1% in group D. Groups B and D, characterized by a higher degree of dyspnea than groups A and C, had five to eight times higher mortality from cardiovascular disease and cancer than did groups A and C. CONCLUSIONS: The new stratification performs well by identifying individuals at risk of exacerbations. Surprisingly, subgroup B, characterized by more severe dyspnea, had significantly poorer survival than group C, in spite of a higher FEV(1) level. This subgroup warrants special attention, as the poor prognosis could be caused by cardiovascular disease or cancer, requiring additional assessment and treatment.
Authors: Michael T Durheim; Patrick J Smith; Michael A Babyak; Stephanie K Mabe; Tereza Martinu; Karen E Welty-Wolf; Charles F Emery; Scott M Palmer; James A Blumenthal Journal: Ann Am Thorac Soc Date: 2015-03
Authors: Timothy E Albertson; Michael Schivo; Amir A Zeki; Samuel Louie; Mark E Sutter; Mark Avdalovic; Andrew L Chan Journal: Drugs Aging Date: 2013-07 Impact factor: 3.923
Authors: Surya P Bhatt; James M Wells; Gregory L Kinney; George R Washko; Matthew Budoff; Young-Il Kim; William C Bailey; Hrudaya Nath; John E Hokanson; Edwin K Silverman; James Crapo; Mark T Dransfield Journal: Thorax Date: 2015-08-17 Impact factor: 9.139