Chest
Original ResearchCopdDistribution and Prognostic Validity of the New Global Initiative for Chronic Obstructive Lung Disease Grading Classification
Section snippets
Materials and Methods
Our study design is of a pooled-analysis of individual patient data,5 from a number of COPD patient cohorts, all in Spain: Galdakao,6 Pamplona,7 Requena,8, 9 Sevilla,10 Tenerife,11 Terrassa,12, 13, 14 and Zaragoza.15 Comprehensive details of the Collaborative Cohorts to Assess Multicomponent Indices of COPD in Spain (COCOMICS) study are available elsewhere (J. M. Marin, MD; I. Alfageme, MD; P. Almagro, MD, et al, unpublished data). Briefly, a minimum data set with age, sex, spirometry, and
Results
We obtained data of 3,633 patients with COPD from 11 cohorts in Spain. They had an age (mean ± SD) of 66.4 ± 9.7 years, 93.3% were men, and 6.7% women. Women were younger (59.8 ± 11.0 years vs 66.9 ± 9.5 years) and more frequently current smokers (43.3% vs 26.8%) than men (both P < .05), but the size of the female group (n = 244) makes us reluctant to report results by sex. At study entry, smoking exposure was substantial (53.4 ± 26.5 pack-years), and 71.0% were former smokers while 27.9% were
Discussion
We report that the new GOLD grading produces an uneven split of the COPD population, one-third each in A and D patient groups, while one in six patients with COPD are B and C, respectively, which to our knowledge is a novel finding. Of interest, its prognostic validity to predict time to death is no different than the old GOLD staging based in spirometry only. We believe the new GOLD grading makes more clinical sense, as decisions on treatment should not only be based (they never were) on
Conclusions
We conclude that the new GOLD grading produces an uneven split of the COPD population, one-third each in A and D patient groups. Its prognostic validity to predict time to death is no different from the old GOLD staging based in spirometry only.
Acknowledgments
Author contributions: Dr Soriano is the guarantor of the manuscript and takes responsibility for its data.
Dr Soriano: contributed to and approved the manuscript, conceived the original idea for the manuscript, developed the plan of analysis, and drafted the report.
Dr Alfageme: contributed to and approved the manuscript and collected clinical data.
Dr Almagro: contributed to and approved the manuscript and collected clinical data.
Dr Casanova: contributed to and approved the manuscript and
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Funding/Support: The authors have reported to CHEST that no funding was received for this study.
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