New COPD Classification Questioned in Recent Study

The new Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 ABCD classification is not better at predicting all-cause and respiratory mortality than the previous 2007 and 2011 GOLD systems, according to a recent study.

For their study, the researchers evaluated 33,765 Danish outpatients with COPD aged 30 years or older who received a primary diagnosis of COPD or respiratory failure with COPD as a secondary diagnosis. All patients included in the study had complete and available data on forced expiratory volume during the first second of forced breath (FEV₁), body mass index (BMI), modified Medical Research Council dyspnea scale score, and smoking status.
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Patients were stratified based on the 2007, 2011, and 2017 GOLD classifications, and patients assigned to the 2017 classification were further divided in 16 subgroups. Additionally, a sub-cohort of 22,621 of these patients who had available data available on cause-specific respiratory mortality were assessed further.

Hazard ratios for all-cause and respiratory mortality were calculated, and the predictive abilities of each GOLD classification were compared via receiver operating curves. Additionally, a sub-cohort of 22,621 of these patients who had data available on cause-specific respiratory mortality were followed

Findings indicated that, when based on ABCD groups alone, the GOLD 2017 classification did not predict mortality better than the previous 2 systems. However, when based on the 16 subgroups (1A to 4D), the 2017 classification provided a more accurate prediction of mortality compared with the previous systems.

“We showed that the new GOLD 2017 ABCD classification does not predict all-cause and respiratory mortality more accurately than the previous GOLD systems from 2007 and 2011,” the researchers concluded.

—Christina Vogt

Reference:

Gedebjerg A, Szépligeti SK, Holm Wackerhausen LM, et al. Prediction of mortality in patients with chronic obstructive pulmonary disease with the new Global Initiative for Chronic Obstructive Lung Disease 2017 classification: a cohort study [Published online January 10, 2018]. The Lancet Respir Med. http://dx.doi.org/10.1016/S2213-2600(18)30002-X.