P120 Real life distribution of COPD severity in the German DACCORD registry: Lung function is the main driver of classification in GOLD group C and D. (12th November 2015)

• Record Type: Journal Article
• Authors: Worth, H; Buhl, R; Criée, C-P; Kardos, P; Mailaender, C; Vogelmeier, CF
• Is Part Of: Thorax. Volume 70(2015)Supplement 3
• Page Start: A135
• Page End: A135
• Publication Date: 2015-11-12
• Subjects: Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thoraxjnl-2015-207770.257
• Languages: English
• ISSNs: 0040-6376

Abstract

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.