2011 GOLD Stages of COPD: Transitions, Predictor Factors and Comparison with 2017 GOLD Stages
Received 26 March 2020
Accepted for publication 12 June 2020
Published 30 June 2020 Volume 2020:15 Pages 1519—1527
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Richard Russell
Roberto Bernabeu-Mora,1– 3 M Piedad Sánchez-Martínez,3,4 Joaquina Montilla-Herrador,3,4 Silvana L Oliveira-Sousa,3,4 Mariano Gacto-Sánchez,5 Francesc Medina-Mirapeix3,4
1Division of Pneumology, Hospital General Universitario Morales Meseguer, Murcia, Spain; 2Department of Internal Medicine, University of Murcia, Murcia, Spain; 3Research Group Fisioterapia y Discapacidad, Instituto Murciano de Investigación Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), El Palmar, Murcia, Spain; 4Department of Physical Therapy, University of Murcia, Murcia, Spain; 5Department of Physical Therapy, EUSES University School, University of Girona, Girona, Spain
Correspondence: Joaquina Montilla-Herrador
Department of Physical Therapy, University of Murcia, Campus de Espinardo, Murcia 30100, Spain
Background: Despite wide use of the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) 2011, little is known about between-stage transitions and what factors predict worsening transitions in patients with chronic obstructive pulmonary disease (COPD).
Objective: To investigate the transition frequency between GOLD 2011 stages among patients with stable COPD over a 2-year follow-up, to identify potential non-pulmonary predictor factors for worsening transitions, and to compare transition frequencies between GOLD 2011 stages and the new GOLD 2017 stages.
Patients and Methods: We prospectively included 137 patients with stable COPD (mean age, 66.9 ± 8.3 years). GOLD 2011 and GOLD 2017 stages were measured at baseline, 1-year follow-up, and 2-year follow-up. To evaluate non-pulmonary variables as potential predictors of worsening transitions, we used regression models adjusted for sociodemographic, clinical, and pulmonary variables using generalized estimating equations.
Results: The study period included 246 opportunities for transition, and 39 worsening transitions occurred within GOLD 2011 stages. Predictors of worsening transitions included BODE index (OR, 1.20; 95% CI, 1.00– 1.44), quadriceps strength (OR, 0.87; 95% CI, 0.76– 0.99), and limited mobility activities (OR, 1.02; 95% CI, 1.00– 1.05). The frequency of worsening transitions for stages B and C differed between GOLD 2011 and GOLD 2017. Stages A and D were the most stable in both classifications.
Conclusion: Non-pulmonary factors predicted worsening transitions among the GOLD 2011 stages of COPD severity. The choice of GOLD 2011 versus GOLD 2017 may influence transition identification, especially for stages B and C.
Keywords: GOLD, quadriceps strength, BODE, mobility activities, COPD exacerbations
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]