The Changes Brought By Updating Of GOLD 2017 Assessment Tool To The Diagnosis And Treatment Of Chronic Obstructive Pulmonary Disease

Objectives:GOLD 2017 has made significant changes to the combined assessment tool for chronic obstructive pulmonary disease.This study was to evaluate the differences between the two assessment results and to analyze their significance in order to improve the understanding and clinical practice of the GOLD 2017 assessment tool.Methods:Patients visited Qilu Hospital of Shandong University with stable chronic obstructive pulmonary disease(COPD)were enrolled into this prospective study from January 2017 to March 2017.All participants met the diagnostic criteria of the Global Initiative on Chronic Obstructive Pulmonary Disease 2017(GOLD 2017).For the selected subjects:1.Inquired and recorded the medicine in detail,complete lung function tests and CAT scores.2.The ABCD grouping of the patients was performed using the GOLD 2016 and GOLD 2017 assessment tools.3.Compare the differences between the groupings of the patients by the two assessment tools.4.Compare the number of patients that long-acting bronchodilator and inhaled corticosteroids were recommended by GOLD 2016 and GOLD 2017.SPSS 21.0 software was applied for statistical treatment.Results:1.110 patients were enrolled,including 99 males,11 females,with an average age of 66.0±7.6 years.2.According to GOLD 2016 combined assessment tool,the distribution of the patients was 30(27.3%)in group A,21(19.1%)in group B,20(18.2%)in group C,39(35.5%)in group D;According to GOLD 2017 combined assessment tool,the distribution of patients was:group A 41(37.3%),group B 37(33.6%),group C 9(8.2%),group D 23(20.9%);There were statistically significant differences between the two assessment tools(p<0.05).Compared with the GOLD 2016 assessment tools,27 patients had a change in the group according to the GOLD 2017 assessment tools,of which 11 patients in group C were reassigned to group A and 16 patients in group D were assigned to Group B.3.The number of patients which the long-acting bronchodilator were recommended by GOLD 2017 was 110/110 cases(100%),higher than 80/110 cases(72.7%)recommended by GOLD 2016,there were statistical significance(P<0.05).The number of patients which the inhaled corticosteroids were recommended by GOLD 2017 was 32/110 cases(29.1%).lower than 59/110 cases(53.6%)recommended by GOLD 2016,there were statistical significance(P<0.05).Conclusion:1.Compared with GOLD 2016,the GOLD 2017 combined COPD assessment tool reassigned patients from high risk(group C and D)to low risk(group A and group B),as a result,these patients need a de-escalation in drug treatment.2.Compared with GOLD 2016,GOLD 2017 recommends a wider range use of long-acting bronchodilators,and a lower range use of inhaled glucocorticoids.