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Comment
. 2023 Oct 26:18:2341-2352.
doi: 10.2147/COPD.S429104. eCollection 2023.

Prediction of Hospitalization and Mortality in Patients with Chronic Obstructive Pulmonary Disease with the New Global Initiative for Chronic Obstructive Lung Disease 2023 Group Classification: A Prospective Cohort and a Retrospective Analysis

Wei Cheng  1 , Aiyuan Zhou  2 , Yuqin Zeng  1 , Ling Lin  1 , Qing Song  1 , Cong Liu  1 , Zijing Zhou  1 , Yating Peng  1 , Min Yang  1 , Lizhen Yang  1 , Yan Chen  1 , Shan Cai  1 , Ping Chen  1
Affiliations
Comment

Prediction of Hospitalization and Mortality in Patients with Chronic Obstructive Pulmonary Disease with the New Global Initiative for Chronic Obstructive Lung Disease 2023 Group Classification: A Prospective Cohort and a Retrospective Analysis

Wei Cheng et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Background: The revised Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 group ABE classification has undergone major modifications, which can simplify clinical assessment and optimize treatment recommendations for Chronic Obstructive Pulmonary Disease (COPD). However, the predictive value of the new grouping classification for prognosis is worth further exploration. We aimed to compare the prediction of hospitalization and mortality between this new GOLD group 2023 ABE classification and the earlier 2017 ABCD classification in a Chinese COPD cohort.

Methods: Data from 2,499 outpatients with COPD, who first registered in the RealDTC study of Second Xiangya Hospital from December 2016 to December 2019, were collected prospectively and assessed retrospectively. Patients were followed up on all-cause mortality until October 2022 or death.

Results: Of the 2,499 patients with COPD, the risk of hospitalization during the first-year follow-up was higher in group E than in groups A and B. The mortality was higher in group E than in groups A and B, and group B was higher than group A. No differences were seen in the area under the curve (AUC) of 2017 vs 2023 GOLD grouping to predict hospitalization. The time-dependent AUC and concordance index for predicting mortality is slightly higher in the GOLD 2017 ABCD than in the 2023 ABE groups. The new GOLD 12-subgroup (1A-4E) classification combining the GOLD 1-4 staging and grouping performed similarly discriminate predictive power for mortality to the GOLD 2017 16-subgroup (A1-4D) classification.

Conclusion: The risk of hospitalization during the first-year follow-up was higher in group E than in groups A and B. The all-cause mortality increased gradually from GOLD group A to E. The GOLD 2023 classification based on ABE groups did not predict mortality better than the earlier 2017 ABCD classifications.

Keywords: COPD; GOLD 2023; hospitalization; mortality.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Comparison of hospitalization rate and mortality within GOLD 2017 ABCD groups and GOLD 2023 ABE groups in COPD patients.
Figure 2
Figure 2
ROC curve analysis between GOLD 2017 group ABCD classification and 2023 group ABE classification in predicting exacerbation and hospitalization in COPD patients.
Figure 3
Figure 3
Time-dependent ROC curve and C-index analysis between GOLD 2017 and 2023 group classification in predicting all-cause mortality.
See this image and copyright information in PMC

Comment on

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