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Prediction of the clinical course of COPD using the old and the new GOLD classification

Peter Lange, Jacob Louis Marott, Morten Dahl, Truls Sylvan Ingebrigtsen, Jørgen Vestbo, Børge Nordestgaard
European Respiratory Journal 2012 40: 1645; DOI:
Peter Lange
1Department of Public Health, Copenhagen University, Copenhagen, Denmark
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Jacob Louis Marott
2Copenhagen City Heart Study, Bispebjerg Hospital, Copenhagen, Denmark
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Morten Dahl
3Dept Clinical Biochemistry, Herlev Hospital, Herlev, Denmark
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Truls Sylvan Ingebrigtsen
2Copenhagen City Heart Study, Bispebjerg Hospital, Copenhagen, Denmark
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Jørgen Vestbo
2Copenhagen City Heart Study, Bispebjerg Hospital, Copenhagen, Denmark
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Børge Nordestgaard
3Dept Clinical Biochemistry, Herlev Hospital, Herlev, Denmark
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Abstract

Using data from The Copenhagen General Population Study and The Copenhagen City Heart Study comprising more than 50,000 individuals, we identified 6,628 persons older than 40 years of age with spirometrically defined COPD (FEV1/FVC ratio below 0.7 and no asthma). These individuals were subdivided according to the GOLD 2007 into stages 1, 2 3 and 4 (based on spirometry only) and according to the GOLD 2011 (using spirometry, mMRC-dyspnea scale and the number of exacerbations in the previous year) into stages A, B, C and D. They were followed for the subsequent year with regard to important COPD outcomes.

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Distribution of individuals with COPD according to the 2007 and 2011 GOLD stratification and the 1-year prognosis

Conclusions:

1. The distribution of the individuals according to the two stratifications differs considerably

2. With regard to prediction of exacerbations, the A-D GOLD 2011 classification performes well

3. Compared with the group D, the lack of symptoms in group C is, not surprisingly, associated with lower frequency of treament with inhaled medications, but also with a sligthly higher frequency of exacerbations

4. Presence of dyspnea and a low level of FEV1 are both predictors of high risk of hospitalisation/casualty ward visit due to COPD, whereas dyspnea seems to be a better predictor of all cause mortality than FEV1.

  • COPD - diagnosis
  • COPD - management
  • COPD - exacerbations
  • © 2012 ERS
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Prediction of the clinical course of COPD using the old and the new GOLD classification
Peter Lange, Jacob Louis Marott, Morten Dahl, Truls Sylvan Ingebrigtsen, Jørgen Vestbo, Børge Nordestgaard
European Respiratory Journal Sep 2012, 40 (Suppl 56) 1645;

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Prediction of the clinical course of COPD using the old and the new GOLD classification
Peter Lange, Jacob Louis Marott, Morten Dahl, Truls Sylvan Ingebrigtsen, Jørgen Vestbo, Børge Nordestgaard
European Respiratory Journal Sep 2012, 40 (Suppl 56) 1645;
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