Does the 2013 GOLD classification improve the ability to predict lung function decline, exacerbations and mortality: a post-hoc analysis of the 4-year UPLIFT trial

摘要: The 2013 GOLD classification system for COPD distinguishes four stages: A (low symptoms, low exacerbation risk), B (high C high risk) and D risk). Assessment of risk is based on history airflow obstruction, whatever results in a higher grouping. previous was solely obstruction. Earlier studies compared the predictive performance new old systems with regards to mortality exacerbations. objective this study compare ability both classifications predict number future (total severe) exacerbations different patient population, add an outcome measure comparison: lung function decline. Patient-level data from UPLIFT trial were used analyze 4-year survival Weibull model, stages at baseline as covariates. generalized linear model numbers per stage. Analyses repeated divided into substages depending history. Lung decline analysed measures model. Mortality increased D, but there no difference between C. For 2–4, curves clearly separated. Yearly rates were: 0.53, 0.72 0.80 2–4; 0.35, 0.45, 0.58 0.74 A-D. Annual 47, 38 26 ml 2–4 44, 48, 39 With fit, performed worse predicting decline, better Distinguishing sub-stages high-risk led substantial improvements. modest step towards phenotype approach. It probably improvement prediction exacerbations, deterioration ClinicalTrials.gov NCT00144339 (September 2, 2005).