Changes in definition lead to changes in the clinical characteristics across COPD categories according to GOLD 2017: a national cross-sectional survey in China

• Published in: International journal of chronic obstructive pulmonary disease 2017-01, Vol.12, p.3095-3102
• Main Authors: Sun, Lina, Chen, Yahong, Wu, Rui, Lu, Ming, Yao, Wanzhen
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Analysis; Body mass index; Bronchitis; Cardiovascular disease; China - epidemiology; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; Comorbidity; Cross-Sectional Studies; Databases, Factual; Demography; Disease Progression; Female; Health risk assessment; Health Status; Health Status Indicators; Health Surveys; Humans; Hypertension; Lung diseases; Male; Medical research; Middle Aged; Normal distribution; Original Research; Patients; Predictive Value of Tests; Prognosis; Pulmonary Disease, Chronic Obstructive - classification; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - mortality; Pulmonary Disease, Chronic Obstructive - therapy; pulmonary function tests; Retrospective Studies; Risk Factors; risk stratification; Severity of Illness Index; Sex Factors; symptom assessment; Terminology as Topic
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S142801

To investigate how the changes of definition in assessment of Global Initiative for Chronic Obstructive Lung Disease (GOLD) stratification 2017 lead to changes of chronic obstructive pulmonary disease (COPD) patient clinical characteristics across categories in China. COPD patients from 11 medical centers in China were stratified into old and new groups A-D twice according to the GOLD 2011 and 2017 comprehensive assessment. Demography and clinical characteristics were compared between old and new groups A-D. In 1,532 COPD patients, the distribution from group A to D was 330 (21.5%), 132 (8.6%), 411 (26.8%), 659 (43.0%) and 557 (36.4%), 405 (26.4%), 184 (12.0%), 386 (25.2%), respectively according to GOLD 2011 and 2017. 46.7% (500/1,070) patients in high-risk groups were regrouped to low-risk groups. Compared to the old groups A and B, the new groups A and B had a higher proportion of males, lower body mass index, higher modified Medical Research Council (mMRC) grade, poor pulmonary function, more patients with chronic bronchitis, and fewer patients with coronary heart disease and hypertension disease. Compared to the old groups C and D, the new groups C and D had older patients, fewer men, better pulmonary functions, frequent acute exacerbations in the previous year, and more patients with chronic bronchitis, coronary heart disease, or diabetes mellitus. The new group D had more patients with stroke than the old group D. In China, GOLD 2017 shifted the overall COPD comprehensive assessments distribution to more low-risk groups. The new high-risk groups had more characteristics associated with high risk of acute exacerbation and mortality. Some of the changes in demography and clinical characteristics of the new low-risk groups were associated with high risk of acute exacerbation and/or mortality.