Department of Respiratory Medicine, University General Hospital of Heraklion, Heraklion, Greece.
1st Department of Respiratory Medicine and Intensive Care Unit, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
BMC Pulm Med. 2021 Jul 9;21(1):216. doi: 10.1186/s12890-021-01576-6.
Chronic obstructive pulmonary disease (COPD) is a multifactorial clinical condition, characterized by chronic progressive (or worsening) respiratory symptoms, structural pulmonary abnormalities, and impaired lung function, and is often accompanied by multiple, clinically significant comorbid disorders. In 2017, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) issued a new report on COPD prevention, diagnosis and management, aiming at personalizing the maintenance therapeutic approach of the stable disease, based on the patients' symptoms and history of exacerbations (ABCD assessment approach). Our objective was to evaluate the implementation of GOLD suggestions in everyday clinical practice in Greece.
This was a cross-sectional observational study. Sixty-five different variables (demographics, vital sign measurements, COPD-related medical history parameters, comorbidities, vaccination data, COPD severity based on spirometry measurements, COPD stage based on the ABCD assessment approach, COPD treatments) were collected from 3615 nation-wide COPD patients (Greece).
The mean age at the time of initial COPD diagnosis was 63.8 (± 10.2). Almost 60% of the subjects were classified into group B, while the remaining patients were falling into groups A (18%) and D (21%), and only a small minority of patients belonged to Group C, according to the ABCD assessment approach. The compliance of respiratory physicians to the GOLD 2017 therapeutic suggestions is problematic, especially when it comes to COPD patients belonging to Group A.
Our data provide valuable information regarding the demographic and medical profile of COPD patients in Greece, the domains which the revised ABCD assessment approach may show some clinical significance on, and the necessity for medical practitioners dealing with COPD patients to adhere closer to international recommendations for the proper management of the disease.
慢性阻塞性肺疾病（COPD）是一种多因素的临床病症，其特征为慢性进行性（或恶化）的呼吸系统症状、肺部结构异常和肺功能受损，并且常伴有多种临床上显著的合并症。2017 年，慢性阻塞性肺疾病全球倡议（GOLD）发布了一份关于 COPD 预防、诊断和管理的新报告，旨在根据患者的症状和加重史（ABCD 评估方法），为稳定期疾病的维持治疗方法提供个性化治疗。我们的目标是评估 GOLD 建议在希腊日常临床实践中的实施情况。
这是一项横断面观察性研究。从希腊全国范围内的 3615 例 COPD 患者中收集了 65 个不同的变量（人口统计学、生命体征测量、COPD 相关病史参数、合并症、疫苗接种数据、基于肺功能测量的 COPD 严重程度、基于 ABCD 评估方法的 COPD 分期、COPD 治疗）。
初次诊断 COPD 时的平均年龄为 63.8（±10.2）岁。根据 ABCD 评估方法，近 60%的患者被归类为 B 组，而其余患者则分别归入 A 组（18%）和 D 组（21%），仅有一小部分患者属于 C 组。呼吸科医生对 GOLD 2017 治疗建议的依从性存在问题，特别是对于属于 A 组的 COPD 患者。
我们的数据提供了有关希腊 COPD 患者的人口统计学和医学特征的有价值的信息，以及修订后的 ABCD 评估方法可能在哪些方面具有临床意义，以及处理 COPD 患者的医疗保健提供者更紧密地遵循国际建议以正确管理该疾病的必要性。
