Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
권호 표지
DOI QR코드

DOI QR Code

The Comparison of Clinical Variables in Two Classifications: GOLD 2017 Combined Assessment and Spirometric Stage of Chronic Obstructive Pulmonary Disease

  • Candemir, Ipek (Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Pulmonary Rehabilitation and Home Care Center) ;
  • Ergun, Pinar (Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Pulmonary Rehabilitation and Home Care Center) ;
  • Kaymaz, Dicle (Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Pulmonary Rehabilitation and Home Care Center) ;
  • Tasdemir, Filiz (Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Pulmonary Rehabilitation and Home Care Center) ;
  • Egesel, Nurcan (Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Pulmonary Rehabilitation and Home Care Center)
  • Received : 2017.10.12
  • Accepted : 2017.12.08
  • Published : 2018.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

Background: There are limited number of studies that investigate clinical variables instead of chronic obstructive lung disease (COPD) management according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 classification. The aim of the study was to investigate whether there was a difference between GOLD 2017 classification and spirometric stage in clinical variables in patients with COPD. The data of 427 male patients with stable COPD were investigated retrospectively. Methods: Patients were allocated into combined assessment of GOLD 2017 and spirometric stage. Age, amount of smoking, pulmonary function, modified Medical Research Council (mMRC), incremental shuttle walk test (ISWT), Hospital Anxiety-Depression Scale (HADS), St. George's Respiratory Questionnaire (SGRQ), body mass index (BMI), and fat free mass index (FFMI) were recorded. Results: Seventy-three (17%) patients were in group A, 103 (24%) constituted group B, 38 (9%) were included in group C, and 213 (50%) comprised group D according to the combined assessment of GOLD 2017. Twenty-three patients (5%) were in stage 1, 95 (22%) were in stage 2, 149 (35%) were in stage 3, and 160 (38%) were in stage 4 according to spirometric stage. According to GOLD 2017, age, amount of smoking, mMRC, BMI, FFMI, SGRQ, HADS, forced vital capacity, forced expiratory volume in 1 second ($FEV_1$), and ISWT were significantly different between groups. Ages, amount of smoking, FFMI, BMI, HADS of group A were different from B and D. Smiliar values of $FEV_1$ were found in A-C and B-D. A and C had smiliar ISWT. According to spirometric stage, BMI, FFMI of stage 4 were statistically different. mMRC, ISWT, and SGRQ of stages 3 and 4 were different from other stages, amongst themselves. $FEV_1$ was correlated with mMRC, SGRQ, anxiety scores, BMI, FFMI, and ISWT. Conclusion: This study showed that the GOLD ABCD classification might not represent the severity of COPD sufficiently well in terms of lung function or exercise capacity. The combination of both spirometric stage and combined assessment of GOLD 2017 is important, especially for estimating clinical variables.

Keywords

References

  1. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of chronic, obstructive pulmonary disease, 2017 report [Internet]. Global Initiative for Chronic Obstructive Lung Disease; 2017 [cited 2017 Dec 5]. Available from: http://goldcopd.org.
  2. Rennard SI, Vestbo J. COPD: the dangerous underestimate of 15%. Lancet 2006;367:1216-9. https://doi.org/10.1016/S0140-6736(06)68516-4
  3. Soriano JB, Lamprecht B, Ramirez AS, Martinez-Camblor P, Kaiser B, Alfageme I, et al. Mortality prediction in chronic obstructive pulmonary disease comparing the GOLD 2007 and 2011 staging systems: a pooled analysis of individual patient data. Lancet Respir Med 2015;3:443-50. https://doi.org/10.1016/S2213-2600(15)00157-5
  4. Goossens LM, Leimer I, Metzdorf N, Becker K, Rutten-van Molken MP. Does the 2013 GOLD classification improve the ability to predict lung function decline, exacerbations and mortality: a post-hoc analysis of the 4-year UPLIFT trial. BMC Pulm Med 2014;14:163. https://doi.org/10.1186/1471-2466-14-163
  5. Kim J, Yoon HI, Oh YM, Lim SY, Lee JH, Kim TH, et al. Lung function decline rates according to GOLD group in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2015;10:1819-27.
  6. Han MK, Muellerova H, Curran-Everett D, Dransfield MT, Washko GR, Regan EA, et al. GOLD 2011 disease severity classification in COPDGene: a prospective cohort study. Lancet Respir Med 2013;1:43-50. https://doi.org/10.1016/S2213-2600(12)70044-9
  7. Fletcher CM. Standardised questionnaire on respiratory symptoms. Br Med J 1960;2:1665.
  8. Singh SJ, Morgan MD, Scott S, Walters D, Hardman AE. Development of a shuttle walking test of disability in patients with chronic airways obstruction. Thorax 1992;47:1019-24. https://doi.org/10.1136/thx.47.12.1019
  9. Aydemir O, Guvenir T, Kuey L, Kultur S. Validity and reliability of Turkish version of Hospital Anxiety and Depression Scale. Turk Psikiyatri Derg 1997;8:280-7.
  10. Jones PW, Quirk FH, Baveystock CM, Littlejohns P. A selfcomplete measure of health status for chronic airflow limitation. The St. George's Respiratory Questionnaire. Am Rev Respir Dis 1992;145:1321-7. https://doi.org/10.1164/ajrccm/145.6.1321
  11. Polatli M, Yorgancioglu A, Aydemir O, Yilmaz Demirci N, Kirkil G, Atis Nayci S, et al. St. George Solunum Anketinin Turkce gecerlilik ve guven ilirligi. Tuberkuloz Toraks 2013;61:81-7. https://doi.org/10.5578/tt.5404
  12. Hurst JR, Vestbo J, Anzueto A, Locantore N, Mullerova H, Tal-Singer R, et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med 2010;363:1128-38. https://doi.org/10.1056/NEJMoa0909883
  13. Anzueto A, Leimer I, Kesten S. Impact of frequency of COPD exacerbations on pulmonary function, health status and clinical outcomes. Int J Chron Obstruct Pulmon Dis 2009;4:245-51.
  14. Kanner RE, Anthonisen NR, Connett JE; Lung Health Study Research Group. Lower respiratory illnesses promote FEV(1) decline in current smokers but not ex-smokers with mild chronic obstructive pulmonary disease: results from the lung health study. Am J Respir Crit Care Med 2001;164:358-64. https://doi.org/10.1164/ajrccm.164.3.2010017
  15. Cote CG, Dordelly LJ, Celli BR. Impact of COPD exacerbations on patient-centered outcomes. Chest 2007;131:696-704. https://doi.org/10.1378/chest.06-1610
  16. Vestbo J, Edwards LD, Scanlon PD, Yates JC, Agusti A, Bakke P, et al. Changes in forced expiratory volume in 1 second over time in COPD. N Engl J Med 2011;365:1184-92. https://doi.org/10.1056/NEJMoa1105482
  17. Agusti A, Calverley PM, Celli B, Coxson HO, Edwards LD, Lomas DA, et al. Characterisation of COPD heterogeneity in the ECLIPSE cohort. Respir Res 2010;11:122. https://doi.org/10.1186/1465-9921-11-122
  18. Seemungal TA, Donaldson GC, Paul EA, Bestall JC, Jeffries DJ, Wedzicha JA. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998;157(5 Pt 1):1418-22. https://doi.org/10.1164/ajrccm.157.5.9709032
  19. Connors AF Jr, Dawson NV, Thomas C, Harrell FE, Jr., Desbiens N, Fulkerson WJ, et al. Outcomes following acute exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments). Am J Respir Crit Care Med 1996;154(4 Pt 1):959-67. https://doi.org/10.1164/ajrccm.154.4.8887592
  20. Gunen H, Hacievliyagil SS, Kosar F, Mutlu LC, Gulbas G, Pehlivan E, et al. Factors affecting survival of hospitalised patients with COPD. Eur Respir J 2005;26:234-41. https://doi.org/10.1183/09031936.05.00024804
  21. Soler-Cataluna JJ, Martinez-Garcia MA, Roman Sanchez P, Salcedo E, Navarro M, Ochando R. Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax 2005;60:925-31. https://doi.org/10.1136/thx.2005.040527
  22. Hallin R, Koivisto-Hursti UK, Lindberg E, Janson C. Nutritional status, dietary energy intake and the risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD). Respir Med 2006;100:561-7. https://doi.org/10.1016/j.rmed.2005.05.020
  23. Zapatero A, Barba R, Ruiz J, Losa JE, Plaza S, Canora J, et al. Malnutrition and obesity: influence in mortality and readmissions in chronic obstructive pulmonary disease patients. J Hum Nutr Diet 2013;26 Suppl 1:16-22. https://doi.org/10.1111/jhn.12088
  24. Donaldson GC, Wilkinson TM, Hurst JR, Perera WR, Wedzicha JA. Exacerbations and time spent outdoors in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2005;171:446-52. https://doi.org/10.1164/rccm.200408-1054OC
  25. Bagade AA, Jiandani MP, Mehta A. Medical research council dyspnoea score and forced expiratory volume in one second as the predictors of vertical climbing in chronic obstructive pulmonary disease patients. Int J Res Med Sci 2017;5:1558-62. https://doi.org/10.18203/2320-6012.ijrms20171265
  26. Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 1999;54:581-6. https://doi.org/10.1136/thx.54.7.581
  27. Kaymaz D, Candemir IC, Ergun P, Demir N, Tasdemir F, Demir P. Relation between upper-limb muscle strength with exercise capacity, quality of life and dyspnea in patients with severe chronic obstructive pulmonary disease. Clin Respir J 2018;12:1257-63. https://doi.org/10.1111/crj.12659
  28. Stenton C. The MRC breathlessness scale. Occup Med (Lond) 2008;58:226-7. https://doi.org/10.1093/occmed/kqm162
  29. Divo M, Cote C, de Torres JP, Casanova C, Marin JM, Pinto-Plata V, et al. Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2012;186:155-61. https://doi.org/10.1164/rccm.201201-0034OC
  30. Abusaid GH, Barbagelata A, Tuero E, Mahmood A, Sharma G. Diastolic dysfunction and COPD exacerbation. Postgrad Med 2009;121:76-81. https://doi.org/10.3810/pgm.2009.07.2033
  31. Exuzides A, Colby C, Briggs AH, Lomas DA, Rutten-van Molken MP, Tabberer M, et al. Statistical modeling of disease progression for chronic obstructive pulmonary disease using data from the ECLIPSE study. Med Decis Making 2017;37:453-68. https://doi.org/10.1177/0272989X15610781

Cited by

  1. Does the GOLD 2017 Classification Improve the Ability to Predict Exacerbation and Mortality? vol.81, pp.3, 2018, https://doi.org/10.4046/trd.2018.0033
  2. Old Friends, Old Wine, and Old COPD Classification Are Best vol.81, pp.4, 2018, https://doi.org/10.4046/trd.2018.0071