Mortality prediction in chronic obstructive pulmonary disease comparing the GOLD 2015 and GOLD 2019 staging: a pooled analysis of individual patient data

Elena García Castillo, Tamara Alonso Pérez, Julio Ancochea, Maria Teresa Pastor Sanz, Pere Almagro, Pablo Martínez-Camblor, Marc Miravitlles, Mónica Rodríguez-Carballeira, Annie Navarro, Bernd Lamprecht, Ana S Ramírez-García Luna, Bernhard Kaiser, Inmaculada Alfageme, Ciro Casanova, Cristóbal Esteban, Juan J Soler-Cataluña, Juan P de-Torres, Bartolomé R Celli, Jose M Marín, Gerben Ter RietPatricia Sobradillo, Peter Lange, Judith Garcia-Aymerich, Josep M Anto, Alice M Turner, MeiLan K Han, Arnulf Langhammer, Sigrid Anna Aalberg Vikjord, Alice Sternberg, Linda Leivseth, Per Bakke, Ane Johannessen, Toru Oga, Borja G Cosío, Andrés Echazarreta, Nicolás Roche, Pierre-Régis Burgel, Don D Sin, Milo A Puhan, Jose Luis López-Campos, Laura Carrasco, Joan B Soriano

Abstract

In 2019, The Global Initiative for Chronic Obstructive Lung Disease (GOLD) modified the grading system for patients with COPD, creating 16 subgroups (1A-4D). As part of the COPD Cohorts Collaborative International Assessment (3CIA) initiative, we aim to compare the mortality prediction of the 2015 and 2019 COPD GOLD staging systems. We studied 17 139 COPD patients from the 3CIA study, selecting those with complete data. Patients were classified by the 2015 and 2019 GOLD ABCD systems, and we compared the predictive ability for 5-year mortality of both classifications. In total, 17 139 patients with COPD were enrolled in 22 cohorts from 11 countries between 2003 and 2017; 8823 of them had complete data and were analysed. Mean±sd age was 63.9±9.8 years and 62.9% were male. GOLD 2019 classified the patients in milder degrees of COPD. For both classifications, group D had higher mortality. 5-year mortality did not differ between groups B and C in GOLD 2015; in GOLD 2019, mortality was greater for group B than C. Patients classified as group A and B had better sensitivity and positive predictive value with the GOLD 2019 classification than GOLD 2015. GOLD 2015 had better sensitivity for group C and D than GOLD 2019. The area under the curve values for 5-year mortality were only 0.67 (95% CI 0.66-0.68) for GOLD 2015 and 0.65 (95% CI 0.63-0.66) for GOLD 2019. The new GOLD 2019 classification does not predict mortality better than the previous GOLD 2015 system.

Original languageEnglish
JournalERJ Open Research
Volume6
Issue number4
ISSN2312-0541
DOIs
Publication statusPublished - Oct 2020

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