Comparison of 2011 and 2007 GOLD guidelines for predicting mortality and hospitalization

Rationale : The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2011 update on COPD bases disease classification on level of dyspnea, exacerbation history and FEV 1 , while the previous GOLD categorized disease severity according to FEV 1 only. Objectives : To examine how GOLD2011 predicts hospitalizations and mortality in an 8-yr-period, and assess differences in predictive ability between GOLD2011 and GOLD2007. Methods : The GenKOLS study comprised 954 COPD patients (FEV 1 /FVC 1 Measurements and Main Results : 20% were classified as GOLD2011 group A, 30% group B, 6% group C and 44% group D. Patients in GOLD2011 group D had OR (95% CI) of 4.1 (2.5, 6.7), 9.6 (3.4, 27.0), and 3.0 (0.7, 13.2) relative to group A for all-cause, respiratory and cardiovascular mortality, respectively, and 3.8 (2.4, 5.9) and 13.0 (6.6, 25.6) for all-cause and respiratory hospitalizations. Associations were similar also for GOLD2007. Adjusted AUC for GOLD2011 and GOLD2007 were 0.82/0.82 for respiratory mortality (p=0.87) and 0.77/0.76 for respiratory hospitalizations (p=0.51). Conclusions : The predictive ability of GOLD2011 did not differ significantly from GOLD2007 in terms of hospitalizations and mortality.