Abstract
To estimate the severity of the disease in outpatients with chronic obstructive pulmonary disease (COPD) in Hunan Province, China and use the subgroup analysis to evaluate the reliability of the new comprehensive evaluation of Global Initiative for Chronic Obstructive Lung Disease (GOLD). COPD outpatients from 12 medical centers in Hunan Province, China were stratified into groups A–D, and group D patients were further stratified into subgroups D1–D3 according to the GOLD 2016 and 2019 comprehensive assessment. Demography, clinical characteristics and medications were compared among groups. In 1017 COPD outpatients, the distribution from group A to D and subgroup D1 to D3 was 41 (4.0%), 249 (24.5%), 17 (1.7%), 710 (69.8%) and 214 (30.2%), 204 (28.7%), 292 (41.1%), according to GOLD 2016. In terms of demographic and clinical characteristics related to A–D groups, there was a significant difference in COPD assessment test (CAT), modified Medical British Research Council (mMRC), the clinical COPD questionnaire(CCQ), age, BMI, education level, smoking history, comorbidities, the course of chronic bronchitis/emphysema, number of exacerbations/hospitalisations in the previous year, treatment protocols, forced expiratory volume in one second (FEV1) % predicted, and FEV1/forced vital capacity (FVC) (p < 0.01). Furthermore, some patients in groups C–D regrouped to groups A–B were all C1 and D1 subgroups according to GOLD 2019. Comparing subgroup D1 with group B, subgroup D2 and subgroup D3, it was found that the demography, clinical characteristics and medications of subgroup D1 were the closest to group B, according to GOLD 2016 (p < 0.01). The disease severity of outpatients with COPD in Hunan Province was more pronounced in group B and D and patients in groups A–D had different demography, clinical characteristics and medications. Subgroup analysis can explain to a certain extent that GOLD2019’s new comprehensive assessment is more reliable than GOLD 2016.
Highlights
Chronic obstructive pulmonary disease (COPD) is a global public health challenge due to its high prevalence and related m ortality[1]
Of the 1017 outpatients recruited to this study, the distribution of comprehensive assessment groups according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2007: Grade I was 8.0% (81/1017), Grade II was 41.4% (421/1017), Grade III was 38.0% (387/1017), and Grade IV was 12.6% (128/1017)
The disease severity of outpatients with chronic obstructive pulmonary disease (COPD) in Hunan Province was more common in group B and D
Summary
Chronic obstructive pulmonary disease (COPD) is a global public health challenge due to its high prevalence and related m ortality[1]. From GOLD 2011 to GOLD 2016, patients were stratified by ABCD assessment tool, which incorporated symptoms, spirometry measure, and frequency of exacerbations. Categories C and D were subdivided into subgroups C1, C2, C3, D1, D2, and D3 They found groups C and D are heterogeneous, being composed of phenotypes with variable risk. In the 2019 update of GOLD document, a refinement of the ABCD assessment tool was proposed that separated spirometry measure from the ABCD g roup[4]. We are not sure whether the refined ABCD assessment scheme is more suitable for the COPD population grouping than the previous creterion. We aimed to estimate the severity of the disease in outpatients with COPD in Hunan Province, China. We use the subgroup analysis to evaluate the reliability of GOLD 2019
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
