Clinical characteristics and outcomes in Japanese patients with COPD according to the 2017 GOLD classification: the Ishinomaki COPD Network Registry
Clinical characteristics and outcomes in Japanese patients with COPD according to the 2017 GOLD classification: the Ishinomaki COPD Network Registry
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DOI：
10.2147/copd.s182905
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发表时间：
2018-01-01
影响因子：
2.8
通讯作者：
Yanai, Masaru
中科院分区：
文献类型：
--
作者：
Kobayashi, Seiichi;Hanagama, Masakazu;Yanai, Masaru
目的：GOLD报告提供了一个框架，用于对COPD进行分类，以反映其临床影响并提供治疗建议。GOLD 2017提出了一个新的分类，根据患者的症状和恶化病史将患者归类为A-D。然而，这些患者的临床特征和结果还没有得到很好的记录。患者和方法：在这项前瞻性观察研究中，我们分析了来自石卷市COPD网络注册中心的数据。所有稳定期COPD患者被分成GOLD 2017定义的四个组。比较两组患者的人口学特征、临床特征、病情加重次数和1年随访病死率。结果：401例慢性阻塞性肺疾病患者确诊为缓解期。A组2 40例(59.9%)，B组12 2例(30.4%)，C组16例(4.0%)，D组23例(5.7%)。在1年的随访期内，B、C、D组患者的病情恶化风险比A组高，分别为2.95、3.92、5.45，C组和D组较A组和B组(均P<；0.001)有更多的恶化，包括恶化导致住院。高危组(C组和D组)较低危组(A组和B组)的体重指数低，症状多，呼吸用药多，气流受限严重。高风险组和低风险组的死亡率没有差异。结论：我们的研究结果提供了证据，表明GOLD 2017分类识别出COPD患者有恶化的风险，包括那些需要住院但预测死亡率较差的患者。
Purpose: The GOLD report provides a framework for classifying COPD in a way that reflects its clinical impact and allows treatment recommendations. The GOLD 2017 proposes a new classification whereby patients are grouped as A-D according to their symptoms and history of exacerbations. However, the clinical characteristics and outcomes in these patients are not well documented.Patients and methods: In this prospective observational study, we analyzed data from the Ishinomaki COPD Network Registry. All patients with stable COPD were classified into the four groups defined by GOLD 2017. The patient demographics, clinical characteristics, number of exacerbations, and mortality rate during 1 year of follow-up were compared between the groups.Results: Four hundred and one patients with stable COPD were identified. There were 240 patients (59.9%) in group A, 122 (30.4%) in group B, 16 (4.0%) in group C, and 23 (5.7%) in group D. Patients in groups B, C, and D had ORs of 2.95, 3.92, and 5.45, respectively, for risk of exacerbation relative to group A. Groups C and D experienced exacerbations more frequently, including exacerbations leading to hospital admission, than groups A and B (both P < 0.001) during the 1-year follow-up period. Patients with a high risk of exacerbation (groups C and D) had a lower body mass index, showed more symptoms, used more respiratory medications, and had more severe airflow limitation than patients at low risk of exacerbation (groups A and B). Mortality was not different between the high-risk and low-risk groups.Conclusion: The results of our study provide evidence that the GOLD 2017 classification identifies patients with COPD at risk of exacerbations, including those requiring hospitalization, but has a poor ability to predict mortality.