New Combined Assessment of Chronic Obstructive Pulmonary Disease: Utilization, Pitfalls, and Association with Spirometry

Overview

Journal Lung India

Specialty Pulmonary Medicine

Date 2019 Apr 30

PMID 31031335

Citations 1

Authors

Ruchi Dua

Ranjeeta Kumari

Vivek Yadav

Mayur Ranjan

Subodh Kumar

Mayank Mishra

SuryaKant Tripathi

Affiliations

Soon will be listed here.

Abstract

Introduction: Classification of chronic obstructive pulmonary (COPD) disease has changed from being solely based on spirometric variables to combined assessment including symptom scores and history of exacerbations/ hospitalizations. There is both lack of awareness regarding change in its assessment as well as underutilization due to time constraints and seeming complexity. Moreover, treatment of COPD needs to be tailored according to the new combined assessment.

Aims: Current study was planned to look at current stratification of patients according to new revised combined assessment (Global Initiative for Chronic Obstructive Lung Disease GOLD 2017) in comparison to old(GOLD 2011) as well as its incorporation in clinical practice. Co-relation between revised combined assessment and spirometric staging was also assessed.

Methods: 418 consecutive COPD patients were enrolled, their dyspnea scores in terms of modified medical research council scale (mMRC), preceding history of hospitalization/ exacerbation over preceding one year and spirometric variables were recorded. Their stratification according to old and new classification recorded. Their past treatment records were reviewed and combined assessment if done recorded.

Results: Substantial shift of categories is seen from C and D respectively to stage A and B on applying the new classification compared to old i.e more severe to less severe. Secondly, revised combined assessment is still highly underutilized. Revised combined assessment has positive co-relation with spirometry and post bronchodilator forced expiratory volume in 1 second(FEV).

Conclusions: Management of substantial number of stable COPD patients may need to be stepped down in accordance with revised combined assessment. There is a need to disseminate information regarding change in COPD classification and stress on its incorporation in our day-to day clinical practice. Revised combined assessment has positive co-relation with spirometry, stressing its utility even in peripheral centers without spirometry facilities.

Citing Articles

Chronic obstructive pulmonary disease burden, grades and erythrocytosis at a tertiary hospital in western Uganda.

Banturaki A, Munyambalu D, Kajoba D, Onchoke V, Peris A, Ryamugwiza P BMC Pulm Med. 2024; 24(1):119.

PMID: 38448860 PMC: 10918867. DOI: 10.1186/s12890-024-02944-8.

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