J Korean Med Sci.  2014 Aug;29(8):1108-1112. 10.3346/jkms.2014.29.8.1108.

Comparison of Korean COPD Guideline and GOLD Initiative Report in Term of Acute Exacerbation: A Validation Study for Korean COPD Guideline

• Hwang YI
• Park YB
• Oh YM
• Lee JH
• Kim TH
• Yoo KH
• Yoon HK
• Rhee CK
• Kim DK
• Shin KC
• Lee SY
• Jung KS

• KMID: 2129606
• DOI: http://doi.org/10.3346/jkms.2014.29.8.1108

Abstract

The purpose of this study was to compare the Korean COPD guideline to GOLD consensus report in terms of acute exacerbation. A total of 361 patients were enrolled in this study, and 16.9% of them experienced acute exacerbation during the follow-up. A total of 6.3% of patients in GOLD A, 9.5% in GOLD B, 7.7% in GOLD C and 17.0% of GOLD D experienced exacerbation during the first year of follow-up, respectively (P=0.09). There was no one who experienced exacerbation during the first year of follow-up in the Korean group 'ga'. The 12-month exacerbation rates of Korean group 'na' and 'da' were 4.5% and 16.0%, respectively (P<0.001). We explore the experience of exacerbation in patients with change of their risk group after applying Korean COPD guideline. A total of 16.0% of the patients who were reclassified from GOLD A to Korean group 'da' experienced acute exacerbation,and 15.3% from GOLD B to Korean group 'da' experienced acute exacerbation. In summary, the Korean COPD guideline is useful to differentiate the high risk from low risk for exacerbation in terms of spirometry. This indicates that application of Korean COPD guideline is appropriate to treat Korean COPD patients.

Keyword

COPD; Guidelines; Assessment; Exacerbation; FEV1

MeSH Terms

Acute Disease
Aged
Disease Progression
Female
Humans
Male
*Practice Guidelines as Topic
Pulmonary Disease, Chronic Obstructive/*classification/*diagnosis
Pulmonary Medicine/*standards
Reproducibility of Results
Republic of Korea
Sensitivity and Specificity
*Severity of Illness Index
Spirometry/*standards

Figure

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  Fig. 1 Korean COPD classification system and GOLD classification system.

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  Fig. 2 Change of risk groups after applying Korean COPD guideline.

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  Fig. 3 Proportion of patients with exacerbation according to each classification system during the first year of follow-up.

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  Fig. 4 Experience of exacerbation after combining 2 COPD classification system.

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