Which GOLD B patients progress to GOLD D with the new classification?

Hye Sook Choi,1 Ju Ock Na,2 Jong Deog Lee,3 Kyeong-Cheol Shin,4 Chin Kook Rhee,5 Yong Il Hwang,6 Seong Yong Lim,7 Kwang Ha Yoo,8 Ki Suck Jung,6 Yong Bum Park9 1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kyunghee University Hospital, Seoul, Republic o...

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Main Authors: Choi HS, Na JO, Lee JD, Shin KC, Rhee CK, Hwang YI, Lim SY, Yoo KH, Jung KS, Park YB
Format: Article
Language:English
Published: Dove Medical Press 2018-10-01
Series:International Journal of COPD
Subjects:
Online Access:https://www.dovepress.com/which-gold-b-patients-progress-to-gold-d-with-the-new-classification-peer-reviewed-article-COPD
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author Choi HS
Na JO
Lee JD
Shin KC
Rhee CK
Hwang YI
Lim SY
Yoo KH
Jung KS
Park YB
author_facet Choi HS
Na JO
Lee JD
Shin KC
Rhee CK
Hwang YI
Lim SY
Yoo KH
Jung KS
Park YB
author_sort Choi HS
collection DOAJ
description Hye Sook Choi,1 Ju Ock Na,2 Jong Deog Lee,3 Kyeong-Cheol Shin,4 Chin Kook Rhee,5 Yong Il Hwang,6 Seong Yong Lim,7 Kwang Ha Yoo,8 Ki Suck Jung,6 Yong Bum Park9 1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kyunghee University Hospital, Seoul, Republic of Korea; 2Division of Pulmonary, Allergy and Critical Care Medicine, Department of Pulmonary Medicine, Soonchunhyang University Cheonan Hospital, Cheonan-si, Republic of Korea; 3Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Gyeongsang National University, Jinju, Republic of Korea; 4Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea; 5Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea; 6Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea; 7Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; 8Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Republic of Korea; 9Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea Background: The 2017 GOLD guidelines revised assessment of COPD by eliminating the FEV1 criterion.Aim: First, we explored the redistribution of 2011 GOLD groups by reference to the 2017 GOLD criteria. Second, we investigated the characteristics of GOLD B patients and the natural course of GOLD B patients according to the 2017 GOLD guidelines.Methods: In total, 2,010 COPD patients in the Korean COPD Subgroup Study cohort were analyzed at baseline and 1 year after enrollment.Results: The 2011 GOLD C patients were redistributed to the 2017 A (64.5%) and C (35.4%) groups. The 2011 GOLD D patients were redistributed to the 2017 B (61.6%) and D (38.6%) groups. The GOLD B patients constituted 62.7% of all patients according to the 2017 classification. Such patients exhibited higher % predicted FEV1 values, longer six-minute walk distances, fewer symptoms, and lower inflammatory marker levels than GOLD D patients. Most GOLD B patients remained in that group (69.1%), but 13.8% progressed to group D at 1-year follow-up. The factors associated with progression from GOLD B to GOLD D were older age, higher modified Medical Research Council (mMRC) and St George’s Respiratory Questionnaire (SGRQ) symptom scores, and a lower % predicted FEV1 value.Conclusion: Severe symptoms, poorer health status, and greater airflow limitation increased patients’ risk of exacerbation and progression from group B to group D when the 2017 GOLD criteria were applied. Keywords: COPD, GOLD B, progression
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spelling doaj.art-c1e52a40a0044aeb82be9fd49a2e41152022-12-22T03:45:48ZengDove Medical PressInternational Journal of COPD1178-20052018-10-01Volume 133233324141351Which GOLD B patients progress to GOLD D with the new classification?Choi HSNa JOLee JDShin KCRhee CKHwang YILim SYYoo KHJung KSPark YBHye Sook Choi,1 Ju Ock Na,2 Jong Deog Lee,3 Kyeong-Cheol Shin,4 Chin Kook Rhee,5 Yong Il Hwang,6 Seong Yong Lim,7 Kwang Ha Yoo,8 Ki Suck Jung,6 Yong Bum Park9 1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kyunghee University Hospital, Seoul, Republic of Korea; 2Division of Pulmonary, Allergy and Critical Care Medicine, Department of Pulmonary Medicine, Soonchunhyang University Cheonan Hospital, Cheonan-si, Republic of Korea; 3Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Gyeongsang National University, Jinju, Republic of Korea; 4Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea; 5Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea; 6Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea; 7Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; 8Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Republic of Korea; 9Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea Background: The 2017 GOLD guidelines revised assessment of COPD by eliminating the FEV1 criterion.Aim: First, we explored the redistribution of 2011 GOLD groups by reference to the 2017 GOLD criteria. Second, we investigated the characteristics of GOLD B patients and the natural course of GOLD B patients according to the 2017 GOLD guidelines.Methods: In total, 2,010 COPD patients in the Korean COPD Subgroup Study cohort were analyzed at baseline and 1 year after enrollment.Results: The 2011 GOLD C patients were redistributed to the 2017 A (64.5%) and C (35.4%) groups. The 2011 GOLD D patients were redistributed to the 2017 B (61.6%) and D (38.6%) groups. The GOLD B patients constituted 62.7% of all patients according to the 2017 classification. Such patients exhibited higher % predicted FEV1 values, longer six-minute walk distances, fewer symptoms, and lower inflammatory marker levels than GOLD D patients. Most GOLD B patients remained in that group (69.1%), but 13.8% progressed to group D at 1-year follow-up. The factors associated with progression from GOLD B to GOLD D were older age, higher modified Medical Research Council (mMRC) and St George’s Respiratory Questionnaire (SGRQ) symptom scores, and a lower % predicted FEV1 value.Conclusion: Severe symptoms, poorer health status, and greater airflow limitation increased patients’ risk of exacerbation and progression from group B to group D when the 2017 GOLD criteria were applied. Keywords: COPD, GOLD B, progressionhttps://www.dovepress.com/which-gold-b-patients-progress-to-gold-d-with-the-new-classification-peer-reviewed-article-COPDCOPDGOLD BProgression
spellingShingle Choi HS
Na JO
Lee JD
Shin KC
Rhee CK
Hwang YI
Lim SY
Yoo KH
Jung KS
Park YB
Which GOLD B patients progress to GOLD D with the new classification?
International Journal of COPD
COPD
GOLD B
Progression
title Which GOLD B patients progress to GOLD D with the new classification?
title_full Which GOLD B patients progress to GOLD D with the new classification?
title_fullStr Which GOLD B patients progress to GOLD D with the new classification?
title_full_unstemmed Which GOLD B patients progress to GOLD D with the new classification?
title_short Which GOLD B patients progress to GOLD D with the new classification?
title_sort which gold b patients progress to gold d with the new classification
topic COPD
GOLD B
Progression
url https://www.dovepress.com/which-gold-b-patients-progress-to-gold-d-with-the-new-classification-peer-reviewed-article-COPD
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