Abstract
Introduction: The GOLD 2014 assessment predicts future exacerbations and mortality risk, separating patients into high symptom groups (B, D) and high risk groups (C, D).
Aim: Our aim was to investigate hospitalisations, exacerbations and mortality in a 3 year prospective study in outpatients with COPD.
Material and Methods: A total of 262 (210 male and 52 female, mean age 66±9) COPD outpatients were recruited. From all patients 20,2 % were no smokers, 25,2% were active smokers (39,1±20,1 pack/years) and 54,6% were ex-smokers (40,0±31,6). During 2012, 2013 and 2014 all COPD related exacerbations and hospitalisations were tracked down. Data for the mortality and the cause of death is gathered from medical records.
Results: According to GOLD 2014 patients were divided as follows: A 69 (26%), B 73 (28%), C 36 (14%) and D 84 (32%). The mean number of hospitalisations for the 3 year period rose from group A to group D (A 0,55±0,9; B 1,41±1,7; C 1,92±2,4; D 2,96±2,9) and in every consecutive year (p<0,001). Mortality was highest in the high symptom groups - D (0,29±0,5) and B (0,19±0,4) and lower in A (0,06±0,2) and C group (0,08±0,3) (p<0,01). Overall mortality rate at the end of the period for all patients was 17,2%.
Conclusion: The new GOLD 2014 assessment proposal is feasible and valid for assessing future hospitalisations (severe exacerbations) which increase from groups A to B to C to D and predict the mortality risk. In the group of smokers (active and ex-smokers) we found that number of exacerbations and hospitalisations are related with age (p<0,01) and smoking history in pack-years (p<0,05).
- Copyright ©ERS 2015