Source: Annual Congress 2002 - Prevalence and costs of COPD
Disease area: Airway diseases

Abstract

The GOLD Classification of COPD depends largely upon spirometric measurements. However, the degree of airflow obstruction is only weakly related to COPD symptoms. The widespread under-utilization of spirometry in the population at risk may not be rectified in the near future. Objective: To identify a combination of risk factors predictive of the presence of COPD and validate those factors against the GOLD Stage Classification. Methods: Smokers and ex-smokers of >=10 PPY and age >=50 years were recruited through a local newspaper. Eligible subjects underwent medical history, physical examination, chest x-ray, spirometry and a set of quality of life questionnaires. Results: 244 subjects completed the study. There were 156 at risk (Normal and Stage 0) and 88 diseased (Stage I, IIA and IIB). Prognostic factors included: age, age of smoking onset, pack-years smoked, gender, smoking status (current or ex-smokers), dyspnea on exertion and presence of both chronic cough and sputum. Significant individual indicators of the disease included: increased age >60 years (P< 0.00005), pack-years smoked >44 (P= 0.0066) and dyspnea on exertion (P= 0.0001). Using stepwise discriminant analysis with all factors in the model, the combination of: age, current smoking and dyspnea on exertion resulted in a correct GOLD Stage Classification in 70.5% (110/156) of the at risk group and 69.3% (61/88) of the diseased group. Overall, 171 of 244 subjects (70.1%) were correctly classified. Conclusions: Increased age, current smoking and dyspnea on exertion have an overall high predictive value for COPD detection with a relatively high degree of concordance (70.1%) to the GOLD Stage Classification. The combined use of these three factors may be an important screening tool for the presence of COPD in the absence of spirometric measures.

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M. R. Maleki-Yazdi, C. K. Lewczuk, F. Kazim, N. B. Choudry, J. M. Haddon (Mississauga, Canada). Validation of non-spirometric predictors of COPD to the GOLD stage classification. Eur Respir J 2002; 20: Suppl. 38, 822

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