Assessment of patients with COPD according to previous and new GOLD: Which stage in which group?

Background: In this study, by comparing the previous and the new GOLD assessment, we aimed to emphasize the importance of recent GOLD classification and combined assessment. Methods: In this study, 270 COPD patients were evaluated prospectively by according to the number of exacerbations in last 12 months, post-bronchodilator FEV 1 values, comorbidities and CAT ( COPD Assessement Test). These patients were compared in terms of the previous and the last assessment of the aGOLD. Results: A total of 270 patients diagnosed with COPD were enrolled into the study. 202 were male (74.8 %) and remains were female ( 25.2 %). The mean age of patiens were 67.4±10.4 years. The mean FEV1 (%) values were 47.1±7.7 and mean CAT score was found 13.2±7.7. In all patients, the mean of exacerbation frequency was 1.64±1.55 per year. While patients classified according to the previous GOLD, 3 patients (1%) in stage 1, 117 patients (43%) in stage 2, 99 patients (37%) in stage 3, 51 patients (19 %) in stage 4 , in new GOLD classification 55 patients (20 %) grade A, 26 patients (10%) in grade B, 62 patients (23%) in grade C, 127 patients (47%) in grade D. A significant correlation was found between CAT scores and exacerbation frequency per year (p<0.001). And also rises in CAT score were significantly related to decreases in FEV1 (p<0.05). Conclusion: In this study, the most variability was observed in stage 2 patients. Based on the new GOLD, 33 % of stage 2 patiens become grade C and D. Consequently, the management of treatment is affected. Therefore, we consider that the new GOLD classification can provide important contributions to the management of patients with COPD.