PT  - JOURNAL ARTICLE
AU  - Selina Dürr
AU  - Stefanie Zogg
AU  - Sabrina Maier
AU  - Esther Helen Steveling
AU  - David Miedinger
AU  - Jörg Daniel Leuppi
TI  - Agreement of severity stages and exacerbations building the new COPD risk groups
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P2497
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P2497.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P2497.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - Background: The guidelines of the Global Initiative for Chronic Obstructive Lung Disease proposed a new classification of chronic obstructive pulmonary disease (COPD) patients into risk groups A to D, which allows a better reflection of the complexity of COPD.Aims: Our aim was to investigate the agreement of spirometer-based severity classification and number of exacerbations, when classifying patients into risk groups A to D. We hypothesized that classification either by severity stages or number of exacerbations yield similar risk group classifications.Methods: This cross-sectional study was conducted at the University Hospital Basel, Switzerland. 87 patients with stable COPD were investigated and classified into risk groups A to D. Severity stages were determined using spirometry, whereas number of exacerbations in the last 12 months was assessed by asking the patients. Moreover, the COPD assessment test (CAT) was completed by every patient. To test the interrater agreement, Cohen’s Kappa was calculated.Results: By using severity stages, there were 29 (33%) patients in risk group A, 40 (46%) in B, 1 (1%) in C and 17 (20%) in D. When using number of exacerbations, there were 30 (35%) patients in risk group A, 48 (55%) in B, 0 (0%) in C and 9 (10%) in D. The interrater agreement between severity stages and number of exacerbations was kappa=0.31, indicating only a slight agreement. Moreover, the correlation between forced expiratory volume in 1 second in % of predicted and number of exacerbations was weak (r=-0.33, p=0.003).Conclusions: When classifying COPD patients into risk groups A to D, the use of objectively measured severity stages might be more accurate than using number of exacerbations.