Validity of the GOLD 2017 classification in the prediction of mortality and respiratory hospitalization in patients with chronic obstructive pulmonary disease
Validity of the GOLD 2017 classification in the prediction of mortality and respiratory hospitalization in patients with chronic obstructive pulmonary disease
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DOI：
10.2147/copd.s191362
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发表时间：
2019-01-01
影响因子：
2.8
通讯作者：
Lee, Jong Deog
中科院分区：
文献类型：
--
作者：
Lee, Seung Jun;Yun, Sang Suk;Lee, Jong Deog
背景：全球慢性阻塞性肺疾病倡议（GOLD）于2017年发布了一份更新文件，排除了患者分类中的肺活量测定参数。这种新的分类系统在预测死亡率和呼吸住院方面的有效性仍不确定。方法：纳入2011年10月至2013年9月接受肺活量测定和6分钟步行试验的慢性阻塞性肺疾病（COPD）门诊患者149例。分析中位期61个月的总死亡率和呼吸系统住院率。对GOLD 2007、GOLD 2011、GOLD 2017和/或BODE指数进行Kaplan-Meier生存分析、带曲线下面积（aus）的受试者工作曲线分析和logistic回归分析，以评估它们预测死亡率和呼吸系统住院的能力。结果：2011年GOLD C或D组42例（53.2%）患者分为2017年GOLD A或B组。GOLD 2017 C组和D组相对于A组呼吸系统住院的优势比分别为7.55 （95% CI, 1.25-45.8）和25.0 （95% CI, 6.01-102.9）。GOLD 2017组A组和B组患者的生存率显著提高(log-rank检验，p
Background: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) released an updated document in 2017 that excluded the spirometric parameter in the classification of patients. The validity of this new classification system in predicting mortality and respiratory hospitalization is still uncertain.Methods: Outpatients (n=149) with chronic obstructive pulmonary disease (COPD) who underwent spirometry and six-minutes walking test from October 2011 to September 2013 were enrolled. The overall mortality and rate of respiratory hospitalization over a median of 61 months were analyzed. Kaplan-Meier survival analyses, receiver operaing curve analyses with areas under the curve (AUCs), and logistic regression analyses for GOLD 2007, GOLD 2011, GOLD 2017, and/or BODE index were performed to evaluate their abilities to predict mortality and respiratory hospitalization.Results: Forty-two (53.2%) patients in 2011 GOLD C or D group were categorized into 2017 GOLD A or B group. The odds ratios of GOLD 2017 group C and group D relative to group A were 7.55 (95% CI, 1.25-45.8) and 25.0 (95% CI, 6.01-102.9) for respiratory hospitalization. Patients in GOLD 2017 group A and group B had significantly better survival (log-rank test, p