Tsoumakidou Maria, Tzanakis Nikolaos, Voulgaraki Olga, Mitrouska Ioanna, Chrysofakis Georgios, Samiou Maria, Siafakas Nikolaos M
Department of Thoracic Medicine, Medical School, University of Crete, P.O. Box 1352, Heraklion 71110, Greece.
Respir Med. 2004 Feb;98(2):178-83. doi: 10.1016/j.rmed.2003.09.011.
Disagreement exists between different COPD guidelines considering classification of severity of the disease. The aim of our study was to determine whether there is any correlation between severity scales of various COPD guidelines (ATS, BTS, ERS and GOLD) and the frequency of hospitalisations for COPD exacerbation. A cohort of 67 COPD patients (65 male 2 female, 45 ex-smokers, 22 current smokers, aged (69.4 +/- 1.1)) was recruited from those admitted in the pulmonary clinic of the University Hospital of Heraklion, Crete for an acute exacerbation. Lung function tests and arterial blood gases analyses were performed during stable conditions at a scheduled visit 2 months after discharge. The patients were stratified using the FEV1 percent-predicted measurement of this visit into mild, moderate and severe in accordance to the ATS, BTS, ERS and GOLD scales of severity. The number of hospitalisations for acute exacerbation was recorded for the following 18 months. A total of 165 exacerbations were recorded. The correlation between the severity of COPD and the number of hospitalisations per year was statistically significant using the GOLD classification system of severity (P = 0.02 and r = 0.294). A weak correlation was also found between the number of hospitalisations and the ERS classification system (P = 0.05 and r = 0.24). No statistically significant correlation was found between the number of hospitalisations and the ATS or BTS severity scales. In conclusion the GOLD and ERS classification systems of severity of COPD correlated to exacerbations causing hospitalisation. The same was not true for the ATS and BTS severity scales. Better correlation was achieved with the GOLD scale.
在慢性阻塞性肺疾病（COPD）的严重程度分类方面，不同的COPD指南之间存在分歧。我们研究的目的是确定各种COPD指南（美国胸科学会（ATS）、英国胸科学会（BTS）、欧洲呼吸学会（ERS）和慢性阻塞性肺疾病全球倡议（GOLD））的严重程度量表与COPD急性加重住院频率之间是否存在任何相关性。从克里特岛伊拉克利翁大学医院肺病科收治的急性加重患者中招募了一组67例COPD患者（65例男性，2例女性，45例既往吸烟者，22例当前吸烟者，年龄（69.4±1.1）岁）。出院后2个月在预定随访时，在病情稳定的情况下进行肺功能测试和动脉血气分析。根据此次就诊时的预测第一秒用力呼气容积（FEV1）百分比测量值，按照ATS、BTS、ERS和GOLD严重程度量表将患者分为轻度、中度和重度。记录接下来18个月内急性加重的住院次数。共记录到165次加重。使用GOLD严重程度分类系统时，COPD严重程度与每年住院次数之间的相关性具有统计学意义（P = 0.02，r = 0.294）。住院次数与ERS分类系统之间也发现了弱相关性（P = 0.05，r = 0.24）。住院次数与ATS或BTS严重程度量表之间未发现统计学上的显著相关性。总之，COPD严重程度的GOLD和ERS分类系统与导致住院的加重情况相关。ATS和BTS严重程度量表则不然。GOLD量表的相关性更好。
