Abstract
Background: It is recognized that FEV1 alone fails to represent the complexity of COPD. GOLD-2013 recommends a multidimensional assessment based on symptoms (mMRC or CAT) and future risk (airflow limitation/exacerbations-hospitalizations). ALAT guidelines also recommend to assess COPD severity based dyspnea severity (mMRC: 0-1 mild, 2 moderate, 3 severe, 4 very-severe), airflow limitation (FEV1%: >80%-mild, 50-80%-moderate, 50-30%-severe, <30%-very-severe) and exacerbations-hospitalizations in the previous-year (severe to very-severe: ≥2 exacerbations or ≥1 hospitalized exacerbation).
Objectives: To compare the COPD prevalence according to GOLD-2013 and ALAT-2014, and the distribution of COPD severity according these two stratifications in a primary-care COPD population from Latin America.
Methods: COPD was defined as post-bronchodilator FEV1/FVC<0.70 and categories according to GOLD-2013 (A,B,C,D) and by ALAT-2014 (mild, moderate, severe, very-severe).
Results: 1,540 completed interview and spirometry, 309 had COPD (FEV1/FVC<0.70 post-BD). According GOLD-2013 COPD prevalence was: 9.3-A, 4.3-B, 2.0-C and 4.6-D. By ALAT was: 2.9-Mild, 9-Moderate, 5.4-Severe, and 2.7-Very severe. The severity proportion according to both classifications is shown.
Conclusions: Patients seem to shift to more severe stages with ALAT classification compared to GOLD-2013.
- Copyright ©the authors 2016