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Abstract
Introduction Currently there is limited real-life data available regarding the distribution of COPD patients using the GOLD 2011 criteria. The German DACCORD registry that collects data from a large ‘real life’ population sample was used to categorise COPD patients according to GOLD 2011.
Methods To be eligible for entry into DACCORD, all patients had to have a diagnosis of COPD (consistent with the German Disease Management Programme definition), and, prior to entry, had to have either newly initiated bronchodilator maintenance medication, or to have a bronchodilator added to their maintenance regimen. No other inclusion criteria were applied, and the only exclusion criterion was a diagnosis of asthma. In primary and secondary care, data were collected from 4,123 COPD outpatients, including spirometry, exacerbations, CAT and mMRC.
Results The mean age of patients was 65.7 years with 40.3% of patients still working and 73.3% patients with duration of disease ≥1 year.
Based on mMRC 0–1, 37.2% of patients had few symptoms (A and C); using CAT <10, only 9.0% were categorised into these two groups. 32.5% of the patients were assigned to C and D groups solely due to FEV1 <50%.
After 12 months, 41.4% patients in GOLD A were categorised in a higher GOLD category, while 42.7% of GOLD D patients were categorised in a lower GOLD category (GOLD categorization based on CAT). 67.6% of patients categorised as D at baseline due to exacerbation history alone were categorised as GOLD B after 1 year follow-up.
Almost 80% of GOLD B patients were still categorised as GOLD B after the observation period of 12 months and were therefore the most stable subgroup with regards to COPD severity according to GOLD 2011 (Figure 1).
Conclusion A significant proportion of patients in the DACCORD registry are classified in GOLD C and D groups based solely on airflow limitation, in accordance with previous studies. Patients categorised as GOLD B were the most stable over the observational period of 12 months according to GOLD 2011. With the prospective collection of exacerbations over the second year of follow-up, a clearer picture of progression of GOLD 2011 categorisation might be drawn.