Abstract
Background: The association of the new GOLD classification with the functionality of patients with chronic obstructive pulmonary disease (COPD) is unknown. Objective: To study which GOLD classification (BCD or 234) better reflects the functionality of patients with COPD. Methods: Ninety patients with COPD were classified according to the new and the previous GOLD classifications (BCD and 234, respectively). Functionality was assessed by the 6-minute walk test (6MWT), activities of daily living (ADL) (London Chest Activity of Daily Living Scale, LCADL) and activity/inactivity variables of physical activity in daily life (PADL) assessed by wearing the Sensewear armband monitor for 2 days. Patients were separated in two groups according to their functionality: for the 6MWT and LCADL, the average values were considered as cut-off points to separate the patients with better or worse functionality; and for PADL these cut-off points were the average of inactive time/day and to achieve (or not) more than 30 minutes/day of moderate intensity activities. Results: The 6MWT was the only of the 4 outcomes which was associated with the GOLD classifications. Out of the 90 patients, 80% (GOLD B), 85% (GOLD C), 44% (GOLD D) and 81% (GOLD 2), 54% (GOLD 3), 43% (GOLD 4) presented better functionality assessed by the 6MWT. In addition, Cramer´s association coefficient values of 6MWT with GOLD BCD and 234 were V=0.36 and V=0.26, respectively. Conclusion: The unidimensional and multidimensional GOLD classifications (234 and BCD) do not reflect well COPD patients' functionality in a broad sense, although these classifications were better associated with functional exercise capacity (6MWT) than with ADL and PADL.
- © 2014 ERS