Clinical and Functional Characteristics of COPD Patients Across GOLD Classifications: Results of a Multicenter Observational Study

Nicola Scichilone, Dejan Radovanovic, Marco Contoli, Claudio Micheletto, Giovanni Sotgiu, Laura Saderi, Fabiano Di Marco, Claudio Micheletto, Paola Rogliani, Paolo Solidoro, Angelo Guido Corsico, Girolamo Pelaia, Fulvio Braido, Pierachille Santus

Risultato della ricerca: Article

Abstract

Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease. The severity grading systems proposed by the Global initiative for Chronic Obstructive Lung Disease (GOLD) have changed over time. The aim of the study was to evaluate if the different GOLD classifications can capture the complexity of the disease by investigating the distribution of lung function and clinical parameters across the GOLD classification systems. This was an observational, retrospective, multicentre study. COPD patients were stratified according to the GOLD severity grading proposed in the 2007, and to the ABCD assessment tool present in the 2011, and 2017 versions of the initiative. Data from body plethysmography, DLCO, comorbidities, exacerbation history, pharmacological therapy and eosinophil counts were collected. A total of 1360 patients (73.4% males) were included in the analysis. Overall, 37% of the patients were severe-very severe according to GOLD 2007. Compared with GOLD 2011, applying the GOLD 2017 criteria, the proportion of the at risk categories (C and D) was reduced by similar to 23%. Impairment in inspiratory capacity, DLCO and the prevalence of emphysema paralleled the GOLD 2007 classification only. The proportion of patients with >= 200 eosinophils/mu L was higher in GOLD 2007 stages 3-4 compared with stages 1-2 (P = 0.008). Eosinophil levels were similar across risk classes in GOLD 2011 and 2017. Overall, 41.8% and 52.4% of the patients in the low risk groups according to GOLD 2011 and 2017 were exposed to inhaled corticosteroids. The GOLD 2011 and 2017 classifications, despite exploring symptoms and exacerbations, might miss other relevant patients' clinical characteristics such as lung function and phenotypes, which have a significant impact on outcomes and disease severity.
Lingua originaleEnglish
pagine (da-a)215-226
Numero di pagine12
RivistaCOPD
Volume16
Stato di pubblicazionePublished - 2019

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Chronic Obstructive Pulmonary Disease
Multicenter Studies
Observational Studies
Eosinophils
Inspiratory Capacity
Lung
Plethysmography
Emphysema
Comorbidity
Adrenal Cortex Hormones
Retrospective Studies
History
Pharmacology
Phenotype

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

Cita questo

Scichilone, N., Radovanovic, D., Contoli, M., Micheletto, C., Sotgiu, G., Saderi, L., ... Santus, P. (2019). Clinical and Functional Characteristics of COPD Patients Across GOLD Classifications: Results of a Multicenter Observational Study. COPD, 16, 215-226.

Clinical and Functional Characteristics of COPD Patients Across GOLD Classifications: Results of a Multicenter Observational Study. / Scichilone, Nicola; Radovanovic, Dejan; Contoli, Marco; Micheletto, Claudio; Sotgiu, Giovanni; Saderi, Laura; Marco, Fabiano Di; Micheletto, Claudio; Rogliani, Paola; Solidoro, Paolo; Corsico, Angelo Guido; Pelaia, Girolamo; Braido, Fulvio; Santus, Pierachille.

In: COPD, Vol. 16, 2019, pag. 215-226.

Risultato della ricerca: Article

Scichilone, N, Radovanovic, D, Contoli, M, Micheletto, C, Sotgiu, G, Saderi, L, Marco, FD, Micheletto, C, Rogliani, P, Solidoro, P, Corsico, AG, Pelaia, G, Braido, F & Santus, P 2019, 'Clinical and Functional Characteristics of COPD Patients Across GOLD Classifications: Results of a Multicenter Observational Study', COPD, vol. 16, pagg. 215-226.
Scichilone, Nicola ; Radovanovic, Dejan ; Contoli, Marco ; Micheletto, Claudio ; Sotgiu, Giovanni ; Saderi, Laura ; Marco, Fabiano Di ; Micheletto, Claudio ; Rogliani, Paola ; Solidoro, Paolo ; Corsico, Angelo Guido ; Pelaia, Girolamo ; Braido, Fulvio ; Santus, Pierachille. / Clinical and Functional Characteristics of COPD Patients Across GOLD Classifications: Results of a Multicenter Observational Study. In: COPD. 2019 ; Vol. 16. pagg. 215-226.
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abstract = "Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease. The severity grading systems proposed by the Global initiative for Chronic Obstructive Lung Disease (GOLD) have changed over time. The aim of the study was to evaluate if the different GOLD classifications can capture the complexity of the disease by investigating the distribution of lung function and clinical parameters across the GOLD classification systems. This was an observational, retrospective, multicentre study. COPD patients were stratified according to the GOLD severity grading proposed in the 2007, and to the ABCD assessment tool present in the 2011, and 2017 versions of the initiative. Data from body plethysmography, DLCO, comorbidities, exacerbation history, pharmacological therapy and eosinophil counts were collected. A total of 1360 patients (73.4{\%} males) were included in the analysis. Overall, 37{\%} of the patients were severe-very severe according to GOLD 2007. Compared with GOLD 2011, applying the GOLD 2017 criteria, the proportion of the at risk categories (C and D) was reduced by similar to 23{\%}. Impairment in inspiratory capacity, DLCO and the prevalence of emphysema paralleled the GOLD 2007 classification only. The proportion of patients with >= 200 eosinophils/mu L was higher in GOLD 2007 stages 3-4 compared with stages 1-2 (P = 0.008). Eosinophil levels were similar across risk classes in GOLD 2011 and 2017. Overall, 41.8{\%} and 52.4{\%} of the patients in the low risk groups according to GOLD 2011 and 2017 were exposed to inhaled corticosteroids. The GOLD 2011 and 2017 classifications, despite exploring symptoms and exacerbations, might miss other relevant patients' clinical characteristics such as lung function and phenotypes, which have a significant impact on outcomes and disease severity.",
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AU - Scichilone, Nicola

AU - Radovanovic, Dejan

AU - Contoli, Marco

AU - Micheletto, Claudio

AU - Sotgiu, Giovanni

AU - Saderi, Laura

AU - Marco, Fabiano Di

AU - Micheletto, Claudio

AU - Rogliani, Paola

AU - Solidoro, Paolo

AU - Corsico, Angelo Guido

AU - Pelaia, Girolamo

AU - Braido, Fulvio

AU - Santus, Pierachille

PY - 2019

Y1 - 2019

N2 - Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease. The severity grading systems proposed by the Global initiative for Chronic Obstructive Lung Disease (GOLD) have changed over time. The aim of the study was to evaluate if the different GOLD classifications can capture the complexity of the disease by investigating the distribution of lung function and clinical parameters across the GOLD classification systems. This was an observational, retrospective, multicentre study. COPD patients were stratified according to the GOLD severity grading proposed in the 2007, and to the ABCD assessment tool present in the 2011, and 2017 versions of the initiative. Data from body plethysmography, DLCO, comorbidities, exacerbation history, pharmacological therapy and eosinophil counts were collected. A total of 1360 patients (73.4% males) were included in the analysis. Overall, 37% of the patients were severe-very severe according to GOLD 2007. Compared with GOLD 2011, applying the GOLD 2017 criteria, the proportion of the at risk categories (C and D) was reduced by similar to 23%. Impairment in inspiratory capacity, DLCO and the prevalence of emphysema paralleled the GOLD 2007 classification only. The proportion of patients with >= 200 eosinophils/mu L was higher in GOLD 2007 stages 3-4 compared with stages 1-2 (P = 0.008). Eosinophil levels were similar across risk classes in GOLD 2011 and 2017. Overall, 41.8% and 52.4% of the patients in the low risk groups according to GOLD 2011 and 2017 were exposed to inhaled corticosteroids. The GOLD 2011 and 2017 classifications, despite exploring symptoms and exacerbations, might miss other relevant patients' clinical characteristics such as lung function and phenotypes, which have a significant impact on outcomes and disease severity.

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