scholarly journals Subgroup Analysis Makes GOLD2019's New Comprehensive Assessment More Convincing：A Cross-Sectional Study in Hunan Province, China

2021 ◽  
Author(s):  
Zhongshang Dai ◽  
Yan Chen ◽  
Huihui Zeng ◽  
Yanan Cui
Keyword(s):  
Subgroup Analysis ◽  
Clinical Characteristics ◽  
Chronic Obstructive Lung Disease ◽  
Cross Sectional Study ◽  
Comprehensive Assessment ◽  
Hunan Province ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Group B ◽  
Group D

Abstract Purpose: To estimate the severity of the disease in outpatients with chronic obstructive pulmonary disease (COPD) in Hunan Province, China and use the subgroup analysis to evaluate the reliability of Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2019.Methods: COPD outpatients from 21 medical centers in Hunan Province, China were stratified into groups A–D, and group D patients were further stratified into subgroups D1–D3 according to the GOLD 2016 comprehensive assessment. Demography, clinical characteristics and medications were compared between groups. Results: In 1,017 COPD outpatients, the distribution from group A to D and subgroup D1 to D3 was 41 (4.0%), 249 (24.5%), 17 (1.7%), 710 (69.8%) and 214 (30.2%), 204 (28.7%), 292 (41.1%), according to GOLD 2016. The clinical characteristics of patients vary from group to group. Some patients in groups C–D regrouped to groups A–B were all C1 and D1 subgroups according to GOLD 2019. Comparing subgroup D1 with group B, group D, subgroup D2 and subgroup D3, it was found that the demography, clinical characteristics and medications of subgroup D1 were the closest to group B, according to GOLD 2016. Conclusion: The disease severity of outpatients with COPD in Hunan Province was more common in group B and D and patients in groups A– D had different demography, clinical characteristics and medications, according to the GOLD 2016. Subgroup analysis can explain to a certain extent that GOLD2019's new comprehensive assessment is more reasonable and reliable than GOLD 2016.

scholarly journals Subgroup analysis reveals higher reliability of the new comprehensive evaluation of Global Initiative for Chronic Obstructive Lung Disease 2019

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Zhongshang Dai ◽  
Huihui Zeng ◽  
Yanan Cui ◽  
Ping Chen ◽  
Yan Chen
Keyword(s):  
Lung Disease ◽  
Subgroup Analysis ◽  
Obstructive Lung Disease ◽  
Clinical Characteristics ◽  
Comprehensive Evaluation ◽  
Chronic Obstructive Lung Disease ◽  
Hunan Province ◽  
Chronic Obstructive ◽  
Global Initiative ◽  
Group B

AbstractTo estimate the severity of the disease in outpatients with chronic obstructive pulmonary disease (COPD) in Hunan Province, China and use the subgroup analysis to evaluate the reliability of the new comprehensive evaluation of Global Initiative for Chronic Obstructive Lung Disease (GOLD). COPD outpatients from 12 medical centers in Hunan Province, China were stratified into groups A–D, and group D patients were further stratified into subgroups D1–D3 according to the GOLD 2016 and 2019 comprehensive assessment. Demography, clinical characteristics and medications were compared among groups. In 1017 COPD outpatients, the distribution from group A to D and subgroup D1 to D3 was 41 (4.0%), 249 (24.5%), 17 (1.7%), 710 (69.8%) and 214 (30.2%), 204 (28.7%), 292 (41.1%), according to GOLD 2016. In terms of demographic and clinical characteristics related to A–D groups, there was a significant difference in COPD assessment test (CAT), modified Medical British Research Council (mMRC), the clinical COPD questionnaire(CCQ), age, BMI, education level, smoking history, comorbidities, the course of chronic bronchitis/emphysema, number of exacerbations/hospitalisations in the previous year, treatment protocols, forced expiratory volume in one second (FEV1) % predicted, and FEV1/forced vital capacity (FVC) (p < 0.01). Furthermore, some patients in groups C–D regrouped to groups A–B were all C1 and D1 subgroups according to GOLD 2019. Comparing subgroup D1 with group B, subgroup D2 and subgroup D3, it was found that the demography, clinical characteristics and medications of subgroup D1 were the closest to group B, according to GOLD 2016 (p < 0.01). The disease severity of outpatients with COPD in Hunan Province was more pronounced in group B and D and patients in groups A–D had different demography, clinical characteristics and medications. Subgroup analysis can explain to a certain extent that GOLD2019’s new comprehensive assessment is more reliable than GOLD 2016.

scholarly journals Classification of COPD patients and compliance to recommended treatment in Greece according to GOLD 2017 report: the RELICO study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nikolaos Tzanakis ◽  
Nikolaos Koulouris ◽  
Katerina Dimakou ◽  
Konstantinos Gourgoulianis ◽  
Epameinondas Kosmas ◽  
...  
Keyword(s):  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Medical Practitioners ◽  
Recommended Treatment ◽  
Copd Patients ◽  
Assessment Approach ◽  
Impaired Lung Function ◽  
Group B

Abstract Background Chronic obstructive pulmonary disease (COPD) is a multifactorial clinical condition, characterized by chronic progressive (or worsening) respiratory symptoms, structural pulmonary abnormalities, and impaired lung function, and is often accompanied by multiple, clinically significant comorbid disorders. In 2017, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) issued a new report on COPD prevention, diagnosis and management, aiming at personalizing the maintenance therapeutic approach of the stable disease, based on the patients’ symptoms and history of exacerbations (ABCD assessment approach). Our objective was to evaluate the implementation of GOLD suggestions in everyday clinical practice in Greece. Methods This was a cross-sectional observational study. Sixty-five different variables (demographics, vital sign measurements, COPD-related medical history parameters, comorbidities, vaccination data, COPD severity based on spirometry measurements, COPD stage based on the ABCD assessment approach, COPD treatments) were collected from 3615 nation-wide COPD patients (Greece). Results The mean age at the time of initial COPD diagnosis was 63.8 (± 10.2). Almost 60% of the subjects were classified into group B, while the remaining patients were falling into groups A (18%) and D (21%), and only a small minority of patients belonged to Group C, according to the ABCD assessment approach. The compliance of respiratory physicians to the GOLD 2017 therapeutic suggestions is problematic, especially when it comes to COPD patients belonging to Group A. Conclusion Our data provide valuable information regarding the demographic and medical profile of COPD patients in Greece, the domains which the revised ABCD assessment approach may show some clinical significance on, and the necessity for medical practitioners dealing with COPD patients to adhere closer to international recommendations for the proper management of the disease.

scholarly journals Respiratory symptoms (COPD Assessment Test and modified Medical Research Council dyspnea scores) and GOLD-ABCD COPD classification: the LASSYC study

2021 ◽  
pp. e20210156
Author(s):  
Maria Montes de Oca1 ◽  
Maria Victorina Lopez Varela2 ◽  
Ana Maria B. Menezes3 ◽  
Fernando C. Wehrmeister3 ◽  
Larissa Ramirez4 ◽  
...  
Keyword(s):  
Respiratory Symptoms ◽  
Early Morning ◽  
Cross Sectional Study ◽  
Kappa Statistics ◽  
Cross Sectional ◽  
Group A ◽  
Group B ◽  
Group D ◽  
Youden’S Index ◽  
Morning Symptoms

Objective: To assess the frequency and severity of 24-hour respiratory symptoms according to COPD GOLD-ABCD classification (2017-version), the distribution of the patients with COPD into GOLD categories using mMRC (=2) or CAT (=10) scores, and agreement between these cut-off points. Methods: In this cross-sectional study (LASSYC study), 24-hour day respiratory symptoms were assessed by the Evaluating Respiratory Symptoms in COPD (E-RS) questionnaire, Nighttime Symptoms of COPD Instrument (NiSCI), Early Morning Symptoms of COPD Instrument (EMSCI), CAT and mMRC scores. Results: Among the 734 patients with COPD, 61% were male, age 69.6±8.7 years, FEV1% post-BD 49.1±17.5%, mMRC 1.8±1.0 and CAT 15.3±.8.1. By mMRC 33.7% were group-A, 29.2% group-B, 10.2% group-C and 26.9% group-D. By CAT 22.3% were group-A, 41% group-B, 4.8% group-C and 31.9% group-D. Using the mMRC the severity of E-RS, NiSCI and EMSCI scores increased from group A to D. Using the CAT, the groups B and D had the higher scores. Agreement between mMRC and CAT was 89.5% (Kappa statistics=75.7%). For mMRC score of 2, CAT score of =11 showed the maximum Youden's index (1.34). For mMRC score of 1, CAT score of =9 and =10 showed the maximum Youden's index (1.48). Conclusion: GOLD COPD classification by CAT seems to better discriminate 24-hour symptoms. Results do not support the equivalent use of CAT=10 and mMRC=2 for assessing symptoms.

scholarly journals Microbial and host immune factors as drivers of COPD

2018 ◽  
Vol 4 (3) ◽  
pp. 00015-2018 ◽  
Author(s):  
Moana Mika ◽  
Izabela Nita ◽  
Laura Morf ◽  
Weihong Qi ◽  
Seraina Beyeler ◽  
...  
Keyword(s):  
Gene Expression ◽  
Respiratory Tract ◽  
Chronic Obstructive Lung Disease ◽  
Cross Sectional Study ◽  
Host Gene ◽  
Chronic Obstructive ◽  
Host Gene Expression ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Severe Copd

Compartmentalisation of the respiratory tract microbiota in patients with different chronic obstructive pulmonary disease (COPD) severity degrees needs to be systematically investigated. In addition, it is unknown if the inflammatory and emphysematous milieux in patients with COPD are associated with changes in the respiratory tract microbiota and host macrophage gene expression.We performed a cross-sectional study to compare non-COPD controls (n=10) to COPD patients (n=32) with different disease severity degrees. Samples (n=187) were obtained from different sites of the upper and lower respiratory tract. Microbiota analyses were performed by 16S ribosomal RNA gene sequencing and host gene expression analyses by quantitative real-time PCR of distinct markers of bronchoalveolar lavage cells.Overall, the microbial communities of severe COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade 3/4) patients clustered significantly differently to controls and less severe COPD (GOLD 1/2) patients (permutational multivariate ANOVA (MANOVA), p=0.001). However, we could not detect significant associations between the different sampling sites in the lower airways. In addition, the chosen set of host gene expression markers significantly separated COPD GOLD 3/4 patients, and we found correlations between the composition of the microbiota and the host data.In conclusion, this study demonstrates associations between host gene expression and microbiota profiles that may influence the course of COPD.

scholarly journals Effect of Smoking on FEF 25, FEF 50 & FEF 75 in Adult Male Smokers

2020 ◽  
Vol 32 (2) ◽  
pp. 81-84
Author(s):  
Shamima Akhter ◽  
Md Ruhul Amin ◽  
Md Noor Nabi ◽  
Nahid Yeasmin ◽  
Mahmudul Hasan ◽  
...  
Keyword(s):  
Adult Male ◽  
Chronic Obstructive Lung Disease ◽  
Control Group ◽  
Chronic Obstructive ◽  
Adult Males ◽  
Cross Sectional ◽  
Group A ◽  
Student’S T ◽  
Medicine Today ◽  
Group B

Introduction:Smoking is most common in East Asia, where two thirds of all adult males smoke tobacco; cigarette smoking is by far the most common. Smoking is the primary cause of chronic obstructive lung disease, chronic bronchitis and other respiratory symptoms. Many studies have shown significant changes of Forced Expiratory Flow (FEF) as FEF 25, FEF 50 and FEF 75 (L/sec) in adult male smokers. Its objective is to assess the change of FEF 25, FEF 50 and FEF 75 (L/sec) in adult male smokers. Materials and Methods: This cross-sectional comparative study was carried out in the Department of Physiology, Dhaka Medical College, Dhaka during the period of July, 2007 to June, 2008. In the present study 30 adult male smokers consuming cigarettes for more than 5 years selected as study group (Group-B) and were matched with 30 adult males who were non-smokers considered as control group (Group-A) for comparison. FEF 25, FEF 50 and FEF 75 (L/sec) were estimated in both Groups. Analysis of data was done with the help of computer by SPSS 12.0 programmer and significant tests were done by unpaired Student’s “t” test. Results: There were statistically significant differences of FEF25, FEF50 and FEF75 (L/sec) in group A vs. group B. Conclusion: From the statistical analysis of the results obtained in the present study and their comparison with those of published reports, it may be concluded that smoking causes significant change of FEF 25, FEF 50 and FEF 75 (L/sec) among the smokers that could be useful in early diagnosis of peripheral airway obstruction. Medicine Today 2020 Vol.32(2): 81-84

scholarly journals The Clinical COPD Questionnaire Correlated with BODE Index-A Cross-Sectional Study

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Shih-Feng Liu ◽  
Ching-Wan Tseng ◽  
Mei-Lien Tu ◽  
Chin-Chou Wang ◽  
Chia-Cheng Tseng ◽  
...  
Keyword(s):  
Health Status ◽  
Airflow Obstruction ◽  
Chronic Obstructive Lung Disease ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Bode Index ◽  
Measure Health Status ◽  
Global Initiative ◽  
A Prospective Study

The Global initiative for Chronic Obstructive Lung Disease (GOLD) staging has widely used in the stratification of the severity of COPD, while BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index was proven superior to FEV1 in predicting mortality, exacerbation and disease severity in patients with COPD. Clinical COPD Questionnaire (CCQ), a questionnaire with ten items categorized into three domains (symptoms, functional state and mental state) was developed to measure health status of COPD patients. However, little is known about the relationship between CCQ score and BODE index. We performed a prospective study with the inclusion of 89 patients who were clinically stable after a 6-week-therapy for COPD symptoms comparing their health status assessed by CCQ, BODE index and GOLD staging. We found that the total CCQ score was correlated with BODE score (P<0.001) and GOLD staging (P<0.001); of three CCQ domains, the functional status correlated the most with BODE index (rS=0.670) and GOLD staging (rS=0.531), followed by symptoms (rS=0.482;rS=0.346, respectively), and mental status (rS=0.340;rS=0.236, respectively). Our data suggest that CCQ is a reliable and convenient alternative tool to evaluate the severity of COPD.

scholarly journals Study of FVC,FEV1 & FEV1/FVC% in adult male smokers

2015 ◽  
Vol 26 (2) ◽  
pp. 61-66
Author(s):  
Shamima Akhter ◽  
Ekramul Mustafa ◽  
Masood Salehin ◽  
Nahid Yeasmin ◽  
Md Ruhul Amin
Keyword(s):  
Adult Male ◽  
Healthy Adult ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Healthy Adult Male ◽  
Group A ◽  
Significant Change ◽  
Group B ◽  
Apparently Healthy

Background: Smoking is most common in East Asia, where two thirds of all adult male smoke tobacco; cigarette smoking is by far the most common. Smoking is the primary cause of chronic obstructive lung disease, chronic bronchitis and other respiratory symptoms. Many studies have shown a significant change of FVC,FEV1 &FEV1/FVC% in adult smokers. Objective: To assess the change of FVC,FEV1 & FEV1/FVC% in adult male smokers. Method: This cross-sectional comparative study was carried out in the Department of Physiology, Dhaka Medical College, Dhaka and National institute of Diseases of Chest and Hospital, Dhaka during the period of 1st July, 2007 to 30th June, 2008. For this purpose, 160 adult male subjects ranging from 18 to 52 years were selected. The subjects were divided into two groups - A and B. Group A consisted of 40 apparently healthy adult male non-smokers. Group B consisted of 120 apparently healthy adult male smokers. The experimental group was again subdivided into group B1 consisting of 40 smokers consuming 2-10 cigarettes/day for more than 5 years, group B2 consisting of 40 smokers consuming 11-20 cigarettes/ day for more than 5 years and group B3 consisting of 40 smokers consuming >20 cigarettes/day for more than 5 years. Analysis of data was done with the help of computer by SPSS 12.0 programmer and significant tests were done by unpaired student’s “t” test. Results: There were no statistically significant differences of FVC,FEV1 in group A vs. group B1, group B2 vs. group B3. The mean FVC,FEV1 were significantly lower (<0.05) in group A vs. group B, group A vs. group B2, group A vs. group B3, group B1 vs. group B2 & group B1 vs. group B3. There were no statistical significant differences of FEV1/ FVC% among different groups. Conclusion: From the statistical analysis of the results obtained in the present study and their comparison with those of published reports, it may be concluded that smoking causes significant change of FVC,FEV1 among the smokers and no significant change of FEV1/FVC% who consumed more than 10 cigarettes per day for more than five years.Bangladesh J Medicine Jul 2015; 26 (2) : 61-66

scholarly journals Evaluation of the Persian Transcript of the COPD Assessment Test in the Measurement of COPD Health Status in Iranian COPD Patients

2015 ◽  
Vol 8 (5) ◽  
pp. 225 ◽  
Author(s):  
Alireza Azargon ◽  
Mohammadreza Gholami ◽  
Ali Farhadi ◽  
Maryam Hadi Chegni ◽  
Abolfazl Zendedel
Keyword(s):  
Disease Severity ◽  
Chronic Obstructive Lung Disease ◽  
Airway Disease ◽  
Cross Sectional Study ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Copd Assessment Test ◽  
The Relationship ◽  
Obstruction Severity

<p><strong>AIM:</strong> Chronic obstructive pulmonary disease is a completely irreversible obstructive airway disease. The COPD assessment test (CAT) is one of the standard methods for the clinical assessment of the disease, which is translated into Persian. This study investigated the reliability of the test and its relationship with the severity of the disease.</p><p><strong>METHODS:</strong> In this cross-sectional study, 120 patients filled out the Persian transcript of the test. After two weeks, the patients filled out the CAT test again. Obstruction severity was determined for all the patients using spirometry, and the patients were categorized into four groups according to the Global Initiative for Chronic Obstructive Lung Disease criteria. The relationship between the test scores and the disease severity wan validated.</p><p><strong>RESULTS:</strong> The mean age of the patients was 51.5 years. The Cronbach's alpha coefficient of the Persian transcript of the test was 0.872 in the first time, and 0.885 in the second time. Intragroup reliability, test re-test and intragroup correlations were significant for all the questions (&lt;0.001). The relationship between the test mean score and obstruction severity was significant, and the correlation between disease categorization in accordance with obstruction severity and categorization according to the test score was significant as well.</p><p><strong>CONCLUSION:</strong> The Persian transcript of the assessment test for COPD was reliable and is directly related to the disease severity according to airflow limitation.</p>

scholarly journals Prevalence and risk factors for COPD in farmers: a cross-sectional controlled study

2015 ◽  
Vol 47 (1) ◽  
pp. 95-103 ◽  
Author(s):  
Alicia Guillien ◽  
Marc Puyraveau ◽  
Thibaud Soumagne ◽  
Stéphanie Guillot ◽  
Fabrice Rannou ◽  
...  
Keyword(s):  
Smoking Status ◽  
Chronic Obstructive Lung Disease ◽  
Cross Sectional Study ◽  
Forced Expiratory Volume ◽  
Controlled Study ◽  
Chronic Obstructive ◽  
Tobacco Exposure ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Cattle Breeders

There are conflicting data regarding the magnitude and determinants of chronic obstructive pulmonary disease (COPD) risk in farmers.In a cross-sectional study of 917 nonfarming working controls and 3787 farmers aged 40–75 years, we assessed respiratory symptoms, tobacco exposure, job history (without direct exposure measurement) and lung function. COPD was defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criterion (post-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <0.70) and by the Quanjer reference equation (post-bronchodilator FEV1/FVC <lower limit of normal (LLN)).The prevalence (95% CI) of COPD according to the GOLD criterion was 5.1% (4.4–5.8%) and 2.9% (1.8–4.0%) in farmers and controls, respectively (p=0.005), and 3.1% (2.5–3.6%) and 1.5% (0.7–2.3%), respectively, for the LLN criterion (p<0.01). For both COPD criteria after adjustment for age, sex and smoking status, COPD prevalence was similar in controls and crop farmers. Compared to controls, four job categories had a higher prevalence of COPD according to the GOLD criterion, namely, cattle breeders, swine breeders, poultry breeders and breeders of two or more livestock types. Among cattle breeders, only those from Franche-Comté had higher prevalence of COPD according to both GOLD and LLN criteria.The prevalence of COPD in farmers is higher than in nonfarming working controls, and depends on the farming activity, the region and the criterion used to define COPD.

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