Chronic obstructive pulmonary disease in Poland: distribution of patients according to the new GOLD 2011 classification. Cross-sectional survey.

Abstract

In 2011 new classification for chronic obstructive pulmonary disease (COPD) was introduced, which are not based on the extent of airflow limitation alone, but also on symptoms and risk of exacerbation. The objective of our work was to present the characteristics of COPD patients according to the GOLD 2011 categories. A cross-sectional survey was performed with the participation of 411 specialists in pneumonology or allergology all over from Poland. In the group of 2271 patients we obtained the following distribution of COPD categories: A 687 (30.3%), B 403 (17.7%), C 256 (11.3%), and D 925 (40.7%). There were very few patients with no exacerbation (1.3%). In subgroups A and B there were no such patients at all. The main reason for classification of patients into categories C and D was the number of exacerbations of COPD (66.0% and 40%, respectively). Cardiovascular comorbidities were more frequent in subgroups B and D, with more symptoms (82%) than in subgroups A and C (57%, p < 0.001). In a large group of patients, representative of the population of COPD patients in Poland, we observed an uneven distribution of patients in the GOLD 2011 categories, with 71% of patients assigned to category A or D. In our study, the main reason for classifying to category C or D was the high risk of disease exacerbation rather than the degree of FEV1 reduction, as noted in other reports.