Please use this identifier to cite or link to this item: doi:10.22028/D291-36768
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Title: Deterioration and Mortality Risk of COPD Patients Not Fitting into Standard GOLD Categories: Results of the COSYCONET Cohort
Author(s): Mayerhofer, Barbara
Jörres, Rudolf A.
Lutter, Johanna I.
Waschki, Benjamin
Kauffmann-Guerrero, Diego
Alter, Peter
Trudzinski, Franziska Christina
Herth, Felix J. F.
Holle, Rolf
Behr, Jürgen
Bals, Robert
Welte, Tobias
Watz, Henrik
Vogelmeier, Claus F.
Kahnert, Kathrin
Language: English
Title: Respiration
Volume: 100
Issue: 4
Pages: 308–317
Publisher/Platform: Karger
Year of Publication: 2021
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: Background: Patients with COPD-specific symptoms and history but FEV1/FVC ratio ≥0.7 are a heterogeneous group (former GOLD grade 0) with uncertainties regarding natural history. Objective: We investigated which lung function measures and cutoff values are predictive for deterioration according to GOLD grades and all-cause mortality. Methods: We used visit 1–4 data of the COSYCONET cohort. Logistic and Cox regression analyses were used to identify relevant parameters. GOLD 0 patients were categorized according to whether they maintained grade 0 over the following 2 visits or deteriorated persistently into grades 1 or 2. Their clinical characteristics were compared with those of GOLD 1 and 2 patients. Results: Among 2,741 patients, 374 GOLD 0, 206 grade 1, and 962 grade 2 patients were identified. GOLD 0 patients were characterized by high symptom burden, comparable to grade 2, and a restrictive lung function pattern; those with FEV1/FVC above 0.75 were unlikely to deteriorate over time into grades 1 and 2, in contrast to those with values between 0.70 and 0.75. Regarding mortality risk in GOLD 0, FEV1%predicted and age were the relevant determinants, whereby a cutoff value of 65% was superior to that of 80% as proposed previously. Conclusions: Regarding patients of the former GOLD grade 0, we identified simple criteria for FEV1/FVC and FEV1% predicted that were relevant for the outcome in terms of deterioration over time and mortality. These criteria might help to identify patients with the typical risk profile of COPD among those not fulfilling spirometric COPD criteria.
DOI of the first publication: 10.1159/000513010
URL of the first publication: https://www.karger.com/Article/FullText/513010
Link to this record: urn:nbn:de:bsz:291--ds-367682
hdl:20.500.11880/33408
http://dx.doi.org/10.22028/D291-36768
ISSN: 1423-0356
0025-7931
Date of registration: 12-Jul-2022
Faculty: M - Medizinische Fakultät
Department: M - Innere Medizin
Professorship: M - Prof. Dr. Robert Bals
Collections:Die Universitätsbibliographie

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