RT Journal Article
SR Electronic
T1 COPD: GOLD 2011 and implications for clinical practice
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P716
VO 42
IS Suppl 57
A1 Dulce Apolinário
A1 Ricardo Reis
A1 Ana Isabel Loureiro
A1 Cláudia Pinto
A1 Abel Afonso
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P716.abstract
AB INTRODUCTION The 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) contains significant changes in terms of classification and treatment. AIMS To compare the GOLD 2011 and 2010 classification system in COPD patients and evaluation of its clinical and therapeutic implications. METHODS Application of both GOLD classifications in COPD patients followed in a Pulmonology consultation who consecutively performed pulmonary function tests (PFTs) from March to August/2012. Data were collected by clinical consultation or telephone interview, two weeks or less after PFTs. RESULTS Sixty-five patients were evaluated (69.2% men, mean age 68.8+10.7years), 58.5% with smoking habits. Using the GOLD 2010, 49.2% were stage II, 23.1% stage III, 13.8% stage IV and 13.8% stage I. With GOLD 2011, 40% belonged to group B, 38.5% group D, 15.4% group A and 6.2% group C. The mean COPD Assessment Test (CAT) score was 17.8+10.1. One year history of exacerbations was present in 49.2% patients. CAT score was correlated with FEV1 (r =-0.39) (p<0.001) and with number of exacerbations (r=+0.47) (p<0.001). Regarding the GOLD classifications, short-acting bronchodilators were, respectively, indicated in 13.8% (2010) and 15.4% (2011), long-acting bronchodilators (LABD) in 49.2% (2010) and 40% (2011), LABD with inhaled corticosteroids (ICC) in 26.2% (2010) and 33.8% (2011) and oxygen in 10.8% (both). The 2011 GOLD classification lead to treatment change in 21.5% patients. CONCLUSIONS We found a significant correlation, albeit weak, between symptoms, and both airflow obstruction and exacerbations reinforcing the inclusion of clinical scores in the classification. Implementation of the 2011 GOLD resulted in treatment changes in 21.5% of patients.