Figures
- Figure 1–
Frequency distribution of the chronic obstructive pulmonary patients studied here according to the 2007 (a) or 2011 (b) Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations. Two subjects were classified as having GOLD stage I but were not included in a) or b). c) Shows the cumulative distribution of the four patient groups for the 2011 GOLD classification within each 2007 GOLD stage.
- Figure 2–
Temporal variation of the four 2011 Global Initiative for Chronic Obstructive Lung Disease groups at recruitment and during the 3-year follow-up. Boxes with percentages indicate the proportion of baseline patients available for examination at the 3-year follow-up. #: death/drop-out/lost for follow-up/missing data.
- Figure 3–
Kaplan–Meier curves for exacerbations (a, d and g), hospitalisations during follow-up (b, e and h) and all-cause mortality (c, f and i) for the 2007 Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations for all patients (a–c), 2011 GOLD recommendations for all patients (d–f) and 2011 GOLD recommendations for patients with forced expiratory volume in 1 s (FEV1) ≥50% of the reference (GOLD stage II) (g–i).
- Figure 4–
Percentage of patients with at least one self-reported comorbidity (a) or persistent, systemic inflammation (b), as described by Agusti et al. [14], in the four groups of the 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) patient classification. a) p<0.05 for all comparisons except for group A versus group B. b) p<0.05 for all comparisons except for group B versus group D. It is of note that both were highest in B patients.
Tables
- Table 1– Outcomes of the four groups of patients as per the 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations [2].
Distribution 2011 GOLD groups p-value A B C D Patients 495 (24) 293 (14) 483 (23) 830 (40) GOLD 2011 assessment variables mMRC dyspnoea score 0.6±0.5 2.3±0.6 0.8±0.4 2.6±0.7 <0.001 FEV1 % predicted 64.2±8.1 61.6±8.2 42.2±11.5 37.2±11.2 <0.001 Exacerbations previous 12 months 0.2±0.4 0.3±0.5 1.0±1.4 1.3±1.4 <0.001 Demographics Age years 63.2±7.2 64.1±7.3 62.9±7.2 63.6±6.9 0.078 Female 191(39) 106(36) 149(31) 280(34) 0.07 Body mass index kg·m−2 26.7±4.8 28.5±6.1 25.2±4.9 26.5±6.1 <0.001 Fat-free mass index kg·m−2 17.3±2.5 18.0±3.5 16.7±2.5 17.1±2.9 <0.001 Smoking, pack-years 48.0±29.4 47.5±25.8 45.2±23.2 51.1±27.7 <0.001 Current smoker 188 (38) 101 (34) 207 (43) 267 (32) 0.001 Symptoms Chronic bronchitis 131 (26) 104 (35) 182 (38) 318 (38) <0.001 SGRQ-C total score 31.9±17.3 55.3±15.5 44.6±16.8 62.2±15.6 <0.001 CESD total score 8.3±8.0 13.8±9.4 9.5±8.2 13.5±9.7 <0.001 Self-reported comorbidities With any comorbidity 383 (77) 248 (85) 350 (72) 690 (83) <0.001 Number of comorbidities 2.0±1.7 2.8±2.2 1.7±1.7 2.3±1.9 <0.001 Physiology FEV1 % reversibility 11.4±13.2 11.8±12.9 10.3±13.5 10.2±14.5 0.035 SaO2 % 95.7±2.1 95.1±2.5 94.4±3.2 93.7±3.2 <0.001 6-min walking distance m 440±106 360±101 408±106 307±114 <0.001 BODE index 0.8±0.8 2.7±1.2 2.6 (1.2 5.1±1.6 <0.001 Imaging % LAA -950 HU 11.8±9.7 12.5±9.9 18.9±11.5 22.5±12.8 <0.001 Outcomes during 3-year follow-up ECOPD per year 0.6±0.8 0.9±1.0 1.3±1.4 1.7±1.7 <0.001 ≥1 hospitalisation 56 (11) 71 (25) 143 (30) 378 (46) <0.001 Mortality rate 22 (4) 28 (10) 41 (8) 114 (14) <0.001 Mortality rate per 100 patient-years 1.6±7.4 3.7±11.5 3.2±10.5 5.5±13.7 <0.001 Rate of annual FEV1 decline mL per year -33.4 (46.2) -38.0 (47.0) -30.2 (45.5) -31.9 (34.6) 0.157 Data are presented as n (%) or mean±sd, unless otherwise stated. mMRC: dyspnoea score according to the modified Medical Research Council questionnaire; FEV1; forced expiratory volume in 1 s; SGRQ-C: St George’s Respiratory Questionnaire for chronic obstructive pulmonary disease (COPD) patients; CESD: Center for Epidemiological Studies Depression Scale; SaO2; arterial oxygen saturation; BODE: body mass index, airflow obstruction, dyspnoea, exercise capacity index; % LAA: percentage of low attenuation areas (i.e. emphysema) in the computed tomography; ECOPD: exacerbation of COPD.
- Table 2– Cox proportional hazards regression analyses for all-cause mortality and hospitalisations during follow-up
Independent variable Estimate p-value Mortality Forced expiratory volume in 1 s % predicted 0.982 (0.969–0.996) 0.011 Age years 1.052 (1.021–1.085) <0.001 Body mass index kg·m−2 0.931 (0.882–0.983) 0.01 Fat-free mass index kg·m−2 1.146 (1.036–1.267) 0.008 Number of comorbidities 1.100 (1.001–1.210) 0.048 6-min walking distance m 0.997 (0.996–0.999) 0.002 Hospitalisations Modified Medical Research Council dyspnoea score 1.246 (1.119–1.387) <0.001 Forced expiratory volume in 1 s % predicted 0.974 (0.966–0.982) <0.001 Exacerbations in previous 12 months 1.195 (1.123–1.270) <0.001 Age years 1.021 (1.005–1.038) 0.01 Body mass index kg·m−2 0.979 (0.960–0.999) 0.04 Hypertension 0.669 (0.526–0.851) 0.001 Angina 0.565 (0.371–0.858) 0.007 Osteoarthritis 0.695 (0.489–0.987) 0.042 Diabetes 0.604 (0.392–0.932) 0.023 Depression requiring treatment 0.657 (0.473–0.912) 0.012 Number of comorbidities 1.209 (1.113–1.314) <0.001 Arterial oxygen saturation % 0.929 (0.902–0.956) <0.001 Data are presented as hazard ratio (95% confidence interval), unless otherwise stated.
Supplementary material
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