RT Journal Article
SR Electronic
T1 Comparison of different staging methods for chronic obstructive pulmonary disease in predicting outcomes
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1700577
DO 10.1183/13993003.00577-2017
A1 Tang-Hsiu Huang
A1 Tzuen-Ren Hsiue
A1 Sheng-Hsiang Lin
A1 Xin-Ming Liao
A1 Po-Lan Su
A1 Chiung-Zuei Chen
YR 2018
UL http://erj.ersjournals.com/content/early/2018/02/01/13993003.00577-2017.abstract
AB Chronic obstructive pulmonary disease (COPD) is commonly staged according to the percentage of predicted forced expiratory volume in one second (FEV1%pred), but other methods have been proposed. In this study we compared seven staging methods in their performance of predicting outcomes.We retrospectively studied 296 COPD outpatients. For each patient the disease severity was staged by separately applying the following methods: the criteria proposed by the Global Initiative for Obstructive Lung Disease (GOLD), quartiles of FEV1%pred and z score of FEV1, quartiles and specified cutoff points of the ratio of FEV1 over height squared ((FEV1·Ht−2)A and (FEV1·Ht−2)B), respectively), and quartiles of the ratio of FEV1 over height cubed (FEV1·Ht−3) and of FEV1 quotient (FEV1Q). We evaluated the performance of these methods in predicting the risks of severe acute exacerbation and the risk of all-cause mortality.Overall, staging based on the reference-independent FEV1Q performed best in predicting the risks of severe acute exacerbation (including frequent exacerbation) and mortality, which was followed by (FEV1·Ht−2)B. The performance of the staging methods could also be influenced by the choice of cutoff values. Future work using large and ethnically diverse populations to refine and validate the cutoff values would enhance the prediction of outcomes.Reference-independent methods for staging COPD performed better than the GOLD criteria in predicting outcomesFootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Tang-Hsiu HuangConflict of interest: Tzuen-Ren HsiueConflict of interest: Sheng-Hsiang LinConflict of interest: Xin-Ming LiaoConflict of interest: Po-Lan SuConflict of interest: Chiung-Zuei Chen