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Comparative Study
. 2020 Jan 31:15:225-233.
doi: 10.2147/COPD.S228958. eCollection 2020.

GOLD Classifications, COPD Hospitalization, and All-Cause Mortality in Chronic Obstructive Pulmonary Disease: The HUNT Study

Laxmi Bhatta  1 , Linda Leivseth  2 , Xiao-Mei Mai  1 , Anne Hildur Henriksen  3   4 , David Carslake  5   6 , Yue Chen  7 , Arnulf Langhammer #  8 , Ben Michael Brumpton #  4   5   9
Affiliations
Comparative Study

GOLD Classifications, COPD Hospitalization, and All-Cause Mortality in Chronic Obstructive Pulmonary Disease: The HUNT Study

Laxmi Bhatta et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Purpose: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has published three classifications of COPD from 2007 to 2017. No studies have investigated the ability of these classifications to predict COPD-related hospitalizations. We aimed to compare the discrimination ability of the GOLD 2007, 2011, and 2017 classifications to predict COPD hospitalization and all-cause mortality.

Patients and methods: We followed 1300 participants with COPD aged ≥40 years who participated in the HUNT Study (1995-1997) through to December 31, 2015. Survival analysis and time-dependent area under receiver operating characteristics curves (AUC) were used to compare the discrimination abilities of the GOLD classifications.

Results: Of the 1300 participants, 522 were hospitalized due to COPD and 896 died over 20.4 years of follow-up. In adjusted models, worsening GOLD 2007, GOLD 2011, or GOLD 2017 categories were associated with higher hazards for COPD hospitalization and all-cause mortality, except for the GOLD 2017 classification and all-cause mortality (ptrend=0.114). In crude models, the AUCs (95% CI) for the GOLD 2007, GOLD 2011, and GOLD 2017 for COPD hospitalization were 63.1 (58.7-66.9), 60.9 (56.1-64.4), and 56.1 (54.0-58.1), respectively, at 20-years' follow-up. Corresponding estimates for all-cause mortality were 57.0 (54.8-59.1), 54.1 (52.1-56.0), and 52.6 (51.0-54.3). The differences in AUCs between the GOLD classifications to predict COPD hospitalization and all-cause mortality were constant over the follow-up time.

Conclusion: The GOLD 2007 classification was better than the GOLD 2011 and 2017 classifications at predicting COPD hospitalization and all-cause mortality.

Keywords: ABCD groups; AUC; COPD hospitalization; GOLD grades; area under curve; mortality.

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Conflict of interest statement

LB reports personal fees for presenting the abstract of this study at Nordic Respiratory Science Forum (NRSF) organized by AstraZeneca in 2019. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Distribution of participants in different GOLD classifications.
Figure 2
Figure 2
AUC curves for the GOLD 2007, GOLD 2011, and GOLD 2017 classifications for (A) COPD hospitalization and (B) all-cause mortality over follow-up time (years) among participants with COPD aged ≥40 years in the HUNT2 study (N=1300).
See this image and copyright information in PMC

References

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