Prognostic Properties of the GOLD 2023 Classification System

• DOI: 10.2147/copd.s410372
• Publication Date: 2023-04-20T02:10:12Z
• Authors: Kristian Brat; Michal Svoboda; Jaromir Zatloukal; Marek Plutinsky; Eva Volakova; Patrice Popelkova; Barbora Novotna; Tomas Dvorak; Vladimir Koblizek
• Keywords: BODE index; Obstructive lung disease; Gold standard (test)

Introduction: Recently, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) has published an update on Strategy Prevention, Diagnosis and Management of COPD, introducing a new classification chronic obstructive pulmonary disease (COPD). Our aim was to assess prognostic value GOLD system in comparison with previous systems (GOLD stages I–IV groups A-D) BODE index. Methods: We used data 784 patients COPD from Czech Multicenter Research Database COPD. Patient survival analyzed use Kaplan–Meier estimate Cox model proportional risks. ROC analysis area under curve (AUC) were classifications The analyses performed software R (version 4.2.0). Results: 782 complete classifications. study population comprised 72.9% men, 89.1% current or former smokers, mean age 66.6 years, BMI 27.4 FEV 1 44.9% predicted. Probability 5-year differed by classification. Application 2023 showed increased risk death group B (HR 1.82, 95% CI 1.14– 2.92; p = 0.013) E 2.48, 1.54– 3.99; p˂0.001). that overall similarly weak A-D schemes (AUCs 0.557– 0.576) lower compared 1– 4 (AUC 0.614) even when index 0.715). Conclusion: concluded poor properties specific prediction tools (eg, index) should be mortality assessment. Keywords: classification, mortality, prognosis