Mortality and Exacerbations by Global Initiative for Chronic Obstructive Lung Disease Groups ABCD: 2011 Versus 2017 in the COPDGene® Cohort

被引：23

作者：

Criner, Rachel N. ^{[1
]}

Labaki, Wassim W. ^{[2
]}

Regan, Elizabeth A. ^{[3
]}

Bon, Jessica M. ^{[4
]}

Soler, Xavier ^{[5
]}

Bhatt, Surya P. ^{[6
]}

Murray, Susan ^{[7
]}

Hokanson, John E. ^{[8
]}

Silverman, Edwin K. ^{[9
]}

Crapo, James D. ^{[3
]}

Curtis, Jeffrey L. ^{[2
,10
]}

Martinez, Fernando J. ^{[2
]}

Make, Barry J. ^{[3
]}

Han, MeiLan K. ^{[2
]}

Martinez, Carlos H. ^{[2
]}

机构：

[1] Univ Michigan, Dept Internal Med, Ann Arbor, MI 48109 USA

[2] Univ Michigan, Div Pulm & Crit Care Med, Ann Arbor, MI 48109 USA

[3] Natl Jewish Hlth, Div Pulm Med, Denver, CO USA

[4] Univ Pittsburgh, Div Pulm & Crit Care Med, Pittsburgh, PA USA

[5] Univ Calif San Diego, Div Pulm Crit Care & Sleep Med, San Diego, CA 92103 USA

[6] Univ Alabama Birmingham, Div Pulm Allergy & Crit Care Med, Birmingham, AL USA

[7] Univ Michigan, Sch Publ Hlth, Ann Arbor, MI 48109 USA

[8] Univ Colorado, Sch Publ Hlth, Aurora, CO USA

[9] Harvard Med Sch, Brigham & Womens Hosp, Channing Div Network Med, Boston, MA 02115 USA

[10] Vet Adm Ann Arbor Healthcare Syst, Ann Arbor, MI USA

来源：

CHRONIC OBSTRUCTIVE PULMONARY DISEASES-JOURNAL OF THE COPD FOUNDATION | 2019年 / 6卷 / 01期

关键词：

chronic obstructive pulmonary disease; COPD; Global Initiative for Chronic Obstructive Lung Disease ABCD groupings 2011 and 2017; exacerbation mortality; PULMONARY-DISEASE; COPD; EPIDEMIOLOGY; PREVENTION; MANAGEMENT; DIAGNOSIS; OUTCOMES; STRATEGY;

D O I：

10.15326/jcopdf.6.1.2018.0130

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Background: The Global initiative for chronic Obstructive Lung Disease (GOLD) ABCD groupings were recently modified. The GOLD 2011 guidelines defined increased risk as forced expiratory volume in 1 second (FEV1) < 50% predicted or >= 2 outpatient or >= 1 hospitalized exacerbation in the prior year, whereas the GOLD 2017 guidelines use only exacerbation history. We compared mortality and exacerbation rates in the Genetic Epidemiology of COPD Study cohort (COPDGene (R)) by 2011 (exacerbation history/FEV1 and dyspnea) versus 2017 (exacerbations and dyspnea) classifications. Methods: Using data from COPDGene (R), we tested associations of ABCD groups with all-cause mortality (Cox models, adjusted for age, sex, race and comorbidities) and longitudinal exacerbations (zero-inflated Poisson models). Results: In 4469 individuals (mean age 63.1 years, 44% female), individual distributions in 2011 versus 2017 systems were: A, 32.0% versus 37.0% B, 17.6% versus 36.3% C, 9.4% versus 4.4% D, 41.0% versus 22.3% (observed agreement 76% [expected 27.8%], Kappa 0.67, p<0.001). Individuals in group D-2011 had 1.1 +/- 1.6 exacerbations/year (mean +/- standard deviation [SD]) versus 1.4 +/- 1.8 for D-2017 (median follow-up 3.7 years). Using group A as reference, for both systems, mortality (median follow-up 6.8 years) was highest in group D (D-2011, [hazard ratio] HR 5.2 [95% confidence interval (CI) 4.2, 6.4]; D-2017, HR 5.5 [4.5, 6.8]), lowest for group C (HR 1.9 [1.4, 2.6] versus HR 1.9 [1.3, 2.8]) and intermediate for group B (HR 2.6 [2.0, 3.4] versus HR 3.4 [2.8, 4.1]). GOLD 2011 had better mortality discrimination (area under the curve [AUC] 0.68) than GOLD 2017 (AUC 0.66, p<0.001 for comparison) but similar exacerbation rate prediction. Conclusions: Relative to the GOLD 2011 consensus statement, discriminate predictive power of the 2017 ABCD classification is similar for exacerbations but lower for survival.

引用

页码：64 / 73

页数：10

共 22 条

[1] Characteristics, stability and outcomes of the 2011 GOLD COPD groups in the ECLIPSE cohort [J].

Agusti, Alvar ;

Edwards, Lisa D. ;

Celli, Bartolome ;

MacNee, William ;

Calverley, Peter M. A. ;

Muellerova, Hana ;

Lomas, David A. ;

Wouters, Emiel ;

Bakke, Per ;

Rennard, Steve ;

Crim, Courtney ;

Miller, Bruce E. ;

Coxson, Harvey O. ;

Yates, Julie C. ;

Tal-Singer, Ruth ;

Vestbo, Jorgen .

EUROPEAN RESPIRATORY JOURNAL, 2013, 42 (03) :636-646

[2] Differential Effect of Modified Medical Research Council Dyspnea, COPD Assessment Test, and Clinical COPD Questionnaire for Symptoms Evaluation Within the New GOLD Staging and Mortality in COPD [J].

Casanova, Ciro ;

Marin, Jose M. ;

Martinez-Gonzalez, Cristina ;

de Lucas-Ramos, Pilar ;

Mir-Viladrich, Isabel ;

Cosio, Borja ;

Peces-Barba, German ;

Solanes-Garcia, Ingrid ;

Agueero, Ramo ;

Feu-Collado, Nuria ;

Calle-Rubio, Miryam ;

Alfageme, Inmaculada ;

de Diego-Damia, Alfredo ;

Irigaray, Rosa ;

Marin, Margarita ;

Balcells, Eva ;

Llunell, Antonia ;

Bautista Galdiz, Juan ;

Golpe, Rafael ;

Lacarcel, Celia ;

Cabrera, Carlos ;

Marin, Alicia ;

Soriano, Joan B. ;

Luis Lopez-Campos, Jose ;

Jose Soler-Cataluna, Juan ;

de-Torres, Juan P. .

CHEST, 2015, 148 (01) :159-168

[3] New GOLD classification: longitudinal data on group assignment [J].

Casanova, Ciro ;

Marin, Jose M. ;

Martinez-Gonzalez, Cristina ;

de Lucas-Ramos, Pilar ;

Mir-Viladrich, Isabel ;

Cosio, Borja ;

Peces-Barba, German ;

Calle-Rubio, Miryam ;

Solanes-Garcia, Ingrid ;

Agueero, Ramn ;

de Diego-Damia, Alfredo ;

Feu-Collado, Nuria ;

Alfageme, Inmaculada ;

Irigaray, Rosa ;

Balcells, Eva ;

Llunell, Antonia ;

Bautista Galdiz, Juan ;

Marin, Margarita ;

Jose Soler-Cataluna, Juan ;

Luis Lopez-Campos, Jose ;

Soriano, Joan B. ;

de-Torres, Juan P. .

RESPIRATORY RESEARCH, 2014, 15

[4] Predictors of survival in COPD:: More than just the FEV1 [J].

Celli, Bartolorne R. ;

Cote, Claudia G. ;

Lareau, Suzanne C. ;

Meek, Paula M. .

RESPIRATORY MEDICINE, 2008, 102 :S27-S35

[5] Design of the Subpopulations and Intermediate Outcomes in COPD Study (SPIROMICS) [J].

Couper, David ;

LaVange, Lisa M. ;

Han, MeiLan ;

Barr, R. Graham ;

Bleecker, Eugene ;

Hoffman, Eric A. ;

Kanner, Richard ;

Kleerup, Eric ;

Martinez, Fernando J. ;

Woodruff, Prescott G. ;

Rennard, Stephen .

THORAX, 2014, 69 (05) :491-494

[6] Prognostic evaluation of COPD patients: GOLD 2011 versus BODE and the COPD comorbidity index COTE [J].

de Torres, Juan P. ;

Casanova, Ciro ;

Marin, Jose M. ;

Pinto-Plata, Victor ;

Divo, Miguel ;

Zulueta, Javier J. ;

Berto, Juan ;

Zagaceta, Jorge ;

Sanchez-Salcedo, Pablo ;

Cabrera, Carlos ;

Carrizo, Santiago ;

Cote, Claudia ;

Celli, Bartolome R. .

THORAX, 2014, 69 (09) :799-804

[7]

FERRIS BG, 1978, AM REV RESPIR DIS, V118, P1

[8] Does the 2013 GOLD classification improve the ability to predict lung function decline, exacerbations and mortality: a post-hoc analysis of the 4-year UPLIFT trial [J].

Goossens, Lucas M. A. ;

Leimer, Inge ;

Metzdorf, Norbert ;

Becker, Karin ;

Rutten-van Molken, Maureen P. M. H. .

BMC PULMONARY MEDICINE, 2014, 14

[9] Susceptibility to Exacerbation in Chronic Obstructive Pulmonary Disease. [J].

Hurst, John R. ;

Vestbo, Jorgen ;

Anzueto, Antonio ;

Locantore, Nicholas ;

Muellerova, Hana ;

Tal-Singer, Ruth ;

Miller, Bruce ;

Lomas, David A. ;

Agusti, Alvar ;

MacNee, William ;

Calverley, Peter ;

Rennard, Stephen ;

Wouters, Emiel F. M. ;

Wedzicha, Jadwiga A. .

NEW ENGLAND JOURNAL OF MEDICINE, 2010, 363 (12) :1128-1138

[10] Comparison of 2011 and 2007 Global Initiative for Chronic Obstructive Lung Disease Guidelines for Predicting Mortality and Hospitalization [J].

Johannessen, Ane ;

Nilsen, Roy M. ;

Storebo, Michael ;

Gulsvik, Amund ;

Eagan, Tomas ;

Bakke, Per .

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2013, 188 (01) :51-59

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