Classification of patients with chronic obstructive pulmonary disease according to the Latin American Thoracic Association (ALAT) staging systems and the global initiative for chronic obstructive pulmonary disease (GOLD)

Several classification systems use different criteria when assessing COPD stages. The objective of this study was to compare the prevalence and distribution of COPD stagesusing Global initiative for chronic Obstructive Lung Disease (GOLD) recommendationsand Latin American Thoracic Association (ALAT)...

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Published in:Archivos de bronconeumología (English ed.) 2017-03, Vol.53 (3), p.98-106
Main Authors: Montes de Oca, Maria, López Varela, María Victorina, Laucho-Contreras, María Eugenia, Casas, Alejandro, Schiavi, Eduardo, Rey, Alejandra, Silva, Alejandra
Format: Article
Language:eng ; spa
Subjects:
Adult
Female
Humans
Male
Middle Aged
Practice Guidelines as Topic
Pulmonary Disease, Chronic Obstructive - classification
Pulmonary Disease, Chronic Obstructive - diagnosis
Severity of Illness Index
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container_title Archivos de bronconeumología (English ed.)
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creator Montes de Oca, Maria
López Varela, María Victorina
Laucho-Contreras, María Eugenia
Casas, Alejandro
Schiavi, Eduardo
Rey, Alejandra
Silva, Alejandra
description Several classification systems use different criteria when assessing COPD stages. The objective of this study was to compare the prevalence and distribution of COPD stagesusing Global initiative for chronic Obstructive Lung Disease (GOLD) recommendationsand Latin American Thoracic Association (ALAT) guidelinesin a primary-care population. Subjects attending routine primary care visits, ≥40 years of age, current or former smokers or exposed to biomass, completed a questionnaire and performed spirometry. COPD was defined as post-bronchodilator FEV /FVC
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The objective of this study was to compare the prevalence and distribution of COPD stagesusing Global initiative for chronic Obstructive Lung Disease (GOLD) recommendationsand Latin American Thoracic Association (ALAT) guidelinesin a primary-care population. Subjects attending routine primary care visits, ≥40 years of age, current or former smokers or exposed to biomass, completed a questionnaire and performed spirometry. COPD was defined as post-bronchodilator FEV /FVC&lt;0.70 and categorised according to GOLD-2013 criteria and ALAT-2014 guideline. The BODEx index was used to assess the prognostic value of the stratification systems. A total of 1743 subjects completed the interview, 1540 performed acceptable spirometry. COPD prevalence according GOLD-2013 was 20.1% and had a U-shaped stage distribution (group A: 9.3%, B: 4.3%, C: 2.0%, D: 4.6%). According to ALAT, prevalence was 19.7% with a bell-shaped stage distribution (mild: 2.9%, moderate: 9%, severe: 5.4%, very-severe: 2.7%). Approximately 73% of patients were stratified as moderate (45.4%) or severe (27.3%) by ALAT guidelines, whereas using GOLD-2013 criteria the majority of subjects (approximately 69%) were in group A (46.3%) or group B (22.7%). BODE index score increased as COPD worsened according to ALAT stratification. This is not observed with GOLD2013 criteria (similar values for B and C groups). Disease stages differ under ALAT and GOLD-2013 criteria. ALAT identified a greater proportion of COPD subjects in the moderate and severe categories compared with GOLD-2013, where the majority were categorised in group A. 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subjects Adult
Female
Humans
Male
Middle Aged
Practice Guidelines as Topic
Pulmonary Disease, Chronic Obstructive - classification
Pulmonary Disease, Chronic Obstructive - diagnosis
Severity of Illness Index
title Classification of patients with chronic obstructive pulmonary disease according to the Latin American Thoracic Association (ALAT) staging systems and the global initiative for chronic obstructive pulmonary disease (GOLD)
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