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Mortality prediction in chronic obstructive pulmonary disease comparing the gold 2015 and gold 2019 staging

A pooled analysis of individual patient data

Article

In 2019, The Global Initiative for Chronic Obstructive Lung Disease (GOLD) modified the grading system for patients with COPD, creating 16 subgroups (1A–4D). As part of the COPD Cohorts Collaborative International Assessment (3CIA) initiative, we aim to compare the mortality prediction of the 2015 and 2019 COPD GOLD staging systems. We studied 17 139 COPD patients from the 3CIA study, selecting those with complete data. Patients were classified by the 2015 and 2019 GOLD ABCD systems, and we compared the predictive ability for 5-year mortality of both classifications. In total, 17139 patients with COPD were enrolled in 22 cohorts from 11 countries between 2003 and 2017; 8823 of them had complete data and were analysed. Mean±SD age was 63.9±9.8 years and 62.9% were male. GOLD 2019 classified the patients in milder degrees of COPD. For both classifications, group D had higher mortality. 5-year mortality did not differ between groups B and C in GOLD 2015; in GOLD 2019, mortality was greater for group B than C. Patients classified as group A and B had better sensitivity and positive predictive value with the GOLD 2019 classification than GOLD 2015. GOLD 2015 had better sensitivity for group C and D than GOLD 2019. The area under the curve values for 5-year mortality were only 0.67 (95% CI 0.66–0.68) for GOLD 2015 and 0.65 (95% CI 0.63–0.66) for GOLD 2019. The new GOLD 2019 classification does not predict mortality better than the previous GOLD 2015 system.

Reference 3CIA collaboration (2020). Mortality prediction in chronic obstructive pulmonary disease comparing the gold 2015 and gold 2019 staging: A pooled analysis of individual patient data. ERJ Open Research, 6(4), Article 00253-2020. https://doi.org/10.1183/23120541.00253-2020
Published by  Urban Vitality 1 January 2020

Publication date

Jan 2020

Author(s)

3CIA collaboration
Elena García Castillo
Tamara Alonso Pérez
Julio Ancochea
Maria Teresa Pastor Sanz
Pere Almagro
Pablo Martínez-Camblor
Marc Miravitlles
Mónica Rodríguez-Carballeira
Annie Navarro
Bernd Lamprecht
Ana S.Ramírez García Luna
Bernhard Kaiser
Inmaculada Alfageme
Ciro Casanova
Cristóbal Esteban
Juan J. Soler-Cataluña
Juan P. De-Torres
Bartolomé R. Celli
Jose M. Marín
Patricia Sobradillo
Peter Lange
Judith Garcia-Aymerich
Josep M. Anto
Alice M. Turner
Meilan K. Han
Arnulf Langhammer
Sigrid Anna Aalberg Vikjord
Alice Sternberg
Linda Leivseth
Per Bakke
Ane Johannessen
Toru Oga
Borja G. Cosío
Andrés Echazarreta
Nicolás Roche
Pierre Régis Burgel
Don D. Sin
Milo A. Puhan
Jose Luis López-Campos
Laura Carrasco
Joan B. Soriano

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