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Objectives: Since GOLD 2017 separates spirometric grades from the ‘ABCD’ groups, there have been some changes in stages of COPD patients. We aimed to evaluate the changes in ABCD stages after GOLD 2017 criteria.
Methods: COPD patients from outpatient clinics of 3 hospitals in Izmir, Turkey were stratified into old and new ABCD groups according to exacerbation history, mMRC evaluation and postbronchodilator spirometry results for both GOLD 2011 and 2017 assessments. The treatment protocols were also evaluated if they were suitable for both classifications.
Results: There were 578 patients (427 men and 151 women) with the mean age of 65.21±10.42. The rate of patients from group A to D was 8%, 10%, 14%, 68% (GOLD 2011) and 19%, 30% 2% and 49% (GOLD 2017) respectively. There were shifts from group C to A (53.4%) and D to B (18.4%). The treatment suitability was 66.3% in GOLD 2011 and 60.9% in GOLD 2017. The most common inappropriate treatment protocol was triple therapy (LAMA + ICS + LABA) in group A for both guidelines. Compared to old high-risk patients (shifting from groups C-D of GOLD 2011 to groups A-B in GOLD 2017), patients in unchanging C-D groups had a higher mMRC score, more exacerbations and better pulmonary functions (p=<0.01 for all parameters).
Conclusion: There were shifts from group C to A and D to B with GOLD 2017, which revealed a shift to more low-risk groups. Despite the updates in guidelines, there are still too much COPD patients with overtreament.