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      International Journal of COPD (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on pathophysiological processes underlying Chronic Obstructive Pulmonary Disease (COPD) interventions, patient focused education, and self-management protocols. Sign up for email alerts here.

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      The effect of comorbidities on COPD assessment: a pilot study.

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          Abstract

          Patients with chronic obstructive pulmonary disease (COPD) frequently suffer from comorbidities. COPD severity may be evaluated by the Global initiative for chronic Obstructive Lung Disease (GOLD) combined risk assessment score (GOLD score). Spirometry, body plethysmography, diffusing capacity of the lung for carbon monoxide (DLCO), and high-resolution computed tomography (HR-CT) measure lung function and elucidate pulmonary pathology. This study assesses associations between GOLD score and measurements of lung function in COPD patients with and without (≤1) comorbidities. It evaluates whether the presence of comorbidities influences evaluation by GOLD score of COPD severity, and questions whether GOLD score describes morbidity rather than COPD severity.

          Most cited references34

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          Bronchiectasis.

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            Reference values for residual volume, functional residual capacity and total lung capacity. ATS Workshop on Lung Volume Measurements. Official Statement of The European Respiratory Society.

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              Comparisons of health status scores with MRC grades in COPD: implications for the GOLD 2011 classification.

              The 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy document recommends assessment of chronic obstructive pulmonary disease (COPD) using symptoms and future exacerbation risk, employing two score cut-points: COPD Assessment Test (CAT) score ≥ 10 or modified Medical Research Council dyspnoea scale (mMRC) grade ≥ 2. To explore the equivalence of these two symptom cut-points, the relationship between the CAT and the mMRC and St George's Respiratory Questionnaire (SGRQ), the Short-form Health Survey and the Functional Assessment of Chronic Illness Therapy Fatigue scores were retrospectively analysed using a primary care dataset. Data from 1817 patients (mean ± SD forced expiratory volume in 1 s 1.6 ± 0.6 L) showed a significant association between mMRC grades and all health status scores (ANOVA p<0.0001). mMRC grade 1 was associated with significant levels of health status impairment (SGRQ 39.4 ± 15.5 and CAT 15.7 ± 7.0); even patients with mMRC grade 0 had modestly elevated scores (SGRQ 28.5 ± 15.1 and CAT 11.7 ± 6.8). An mMRC grading ≥ 2 categorised 57.2% patients with low symptom (groups A and C) versus 17.2% with the CAT. Using the mMRC cut-point (≥ 1) resulted in similar GOLD group categorisations as the CAT (18.9%). The mMRC showed a clear relationship with health status scores; even low mMRC grades were associated with health status impairment. Cut-points of mMRC grade ≥ 1 and CAT score ≥ 10 were approximately equivalent in determining low-symptom patients. The GOLD assessment framework may require refinement.
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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                International journal of chronic obstructive pulmonary disease
                Informa UK Limited
                1178-2005
                1176-9106
                2015
                : 10
                Affiliations
                [1 ] Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark ; Respiratory and Critical Care Group (RCARE), Centre for Model-Based Medical Decision Support Systems, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark ; The Clinical Institute, Aalborg University Hospital, Aalborg, Denmark.
                [2 ] Respiratory and Critical Care Group (RCARE), Centre for Model-Based Medical Decision Support Systems, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
                [3 ] Department of Radiology, Vendsyssel Hospital, Hjørring, Denmark.
                [4 ] Department of Radiology, Horsens Regional Hospital, Horsens, Denmark ; Department of Radiology, Aalborg University Hospital, Aalborg, Denmark.
                Article
                copd-10-429
                10.2147/COPD.S76124
                4348050
                25750525
                6d5f68a3-090d-48f6-a6b9-be41ad3f0e70
                History

                GOLD,diffusing capacity of the lung for carbon monoxide,high resolution computerized tomography,inspiratory capacity,mMRC,total lung capacity

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