Please use this identifier to cite or link to this item: http://hdl.handle.net/2381/39627
Title: Characteristics and longitudinal progression of chronic obstructive pulmonary disease in GOLD B patients.
Authors: Lawrence, Philip J.
Kolsum, Umme
Gupta, Vandana
Donaldson, Gavin
Singh, Richa
Barker, Bethan
George, Leena
Webb, Adam
Brookes, Anthony J.
Brightling, Christopher
Wedzicha, Jawiga
Singh, Dave
First Published: 20-Feb-2017
Publisher: BioMed Central
Citation: BMC Pulmonary Medicine, 2017, 17 (1), pg. 42
Abstract: BACKGROUND: The characteristics and natural history of GOLD B COPD patients are not well described. The clinical characteristics and natural history of GOLD B patients over 1 year in a multicentre cohort of COPD patients in the COPDMAP study were assessed. We aimed to identify the subgroup of patients who progressed to GOLD D (unstable GOLD B patients) and identify characteristics associated with progression. METHODS: Three hundred seventy COPD patients were assessed at baseline and 12 months thereafter. Demographics, lung function, health status, 6 min walk tests and levels of systemic inflammation were assessed. Students t tests and Mann Whitney-U tests were used. RESULTS: One hundred seven (28.9%) of patients were categorised as GOLD B at baseline. These GOLD B patients had similar FEV1 to GOLD A patients (66% predicted). More GOLD B patients were current smokers (p = 0.031), had chronic bronchitis (p = 0.0003) and cardiovascular comorbidities (p = 0.019) compared to GOLD A. At 12 months, 25.3% of GOLD B patients progressed to GOLD D. These patients who progressed (unstable patients) had worse health status and symptoms (SGRQ-C Total, 50.0 v 41.1, p = 0.019 and CAT, 21.0 v 14.0, p = 0.006) and lower FEV1 (60% v 69% p = 0.014) at baseline compared to stable patients who remained in GOLD B. CONCLUSIONS: Unstable GOLD B patients who progressed to GOLD D had a higher level of symptoms at baseline. A high symptom burden may predict an increased likelihood of disease progression in GOLD B patients.
DOI Link: 10.1186/s12890-017-0384-8
eISSN: 1471-2466
Links: https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-017-0384-8#Declarations
http://hdl.handle.net/2381/39627
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © the authors, 2017. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Appears in Collections:Published Articles, Dept. of Infection, Immunity and Inflammation

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