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Respir Med. 2014 Jan;108(1):129-35. doi: 10.1016/j.rmed.2013.08.015. Epub 2013 Aug 30.

Characteristics of a COPD population categorised using the GOLD framework by health status and exacerbations.

Author information

1
Clinical Science, St George's, University of London, London, United Kingdom. Electronic address: pjones@sgul.ac.uk.
2
Respiratory Centre of Excellence, GSK, Uxbridge, United Kingdom. Electronic address: gilbert.a.nadeau@gsk.com.
3
Adelphi Real World, Adelphi Group, Macclesfield, United Kingdom. Electronic address: Mark.Small@adelphigroup.com.
4
Respiratory Centre of Excellence, GSK, Uxbridge, United Kingdom. Electronic address: lukasz.p.adamek@gsk.com.

Abstract

GOLD proposed a COPD assessment framework focussed on symptoms measured by the COPD Assessment Test™ (CAT) or the mMRC and on exacerbation risk based on poor lung function (FEV1 <50%) or a history of ≥2 exacerbations in the previous year. This analysis examined the characteristics of COPD patients recruited from routine clinical settings and classified using the GOLD framework. 1041 European COPD patients (38.5% from primary care) from the Adelphi Respiratory Disease Specific Programme with information on CAT, mMRC, spirometry and exacerbation history in the previous year were analysed. Their mean age was 64.9 ± 9.9 years and mean FEV1 was 62.5 ± 17.8% predicted; 80% were in GOLD 2 spirometric grade or milder. CAT and mMRC cut points identified different groups of patients; using CAT, the composition was: Group A 9.3%, Group B 48.5%, Group C 0.7% and Group D 41.5%. 80% were classified as high risk based on exacerbation history and 25% of patients in a low risk category (GOLD A and B) had 1 exacerbation in the previous year. The incidence of diabetes, hypertension and hyperlipidaemia rose with worsening GOLD group (all p < 0.0001); diabetes GOLD A 4%, GOLD B 16%, GOLD D 29%; hypertension GOLD A 38%, GOLD B 55%, GOLD D 65%; hyperlipidaemia GOLD A 13%, GOLD B 30%, GOLD D 37%. In patients seen in routine clinical settings, 25% of GOLD low risk patients had one exacerbation per year and the incidence of cardio-vascular and metabolic diseases increases with worsening GOLD group.

KEYWORDS:

CAT; COPD; Exacerbations; GOLD

PMID:
24041746
DOI:
10.1016/j.rmed.2013.08.015
[Indexed for MEDLINE]
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