Impact of Applying the Global Lung Initiative Criteria for Airway Obstruction in GOLD Defined COPD Cohorts:: The BODE and CHAIN Experience

• Juan P. de-Torres ^[1] ; Ciro Casanova ^[2] ; José M. Marín ^[3] ; Carlos Cabrera ^[8] ; Marta Marína ^[9] ; Ana Ezponda ^[1] ; Borja G. Cosio ^[4] ; Cristina Martínez ^[5] ; Ingrid Solanes ^[10] ; Antonia Fuster ^[11] ; Myriam Calle ^[6] ; Germán Peces-Barba ^[7] ; Carolina Gotera ^[7] ; Nuria Feu-Collado ^[12] ; Alicia Marin ^[13] ; Ana Belén Alcaide ^[1] ; Matilde Sangro ^[1] ; Gorka Bastarrika ^[1] ; Bartolome R. Celli ^[14]
  1. [1] Clínica Universitaria de Navarra

     Clínica Universitaria de Navarra

     Pamplona, España

     
  2. [2] Hospital Universitario Nuestra Señora de Candelaria

     Hospital Universitario Nuestra Señora de Candelaria

     Santa Cruz de Tenerife, España

     
  3. [3] Hospital Miguel Servet

     Hospital Miguel Servet

     Zaragoza, España

     
  4. [4] Hospital Universitario Son Espases

     Hospital Universitario Son Espases

     Palma de Mallorca, España

     
  5. [5] Instituto de Investigación Sanitaria del Principado de Asturias

     Instituto de Investigación Sanitaria del Principado de Asturias

     Oviedo, España

     
  6. [6] Hospital Clínico San Carlos de Madrid

     Hospital Clínico San Carlos de Madrid

     Madrid, España

     
  7. [7] Fundación Jiménez Díaz

     Fundación Jiménez Díaz

     Madrid, España

     
  8. [8] Pulmonary Department, Hospital Universitario Doctor Negrín, Las Palmas, Spain
  9. [9] Hospital Universitario Lozano Blesa, Zaragoza, Spain
  10. [10] Pulmonary Department, Hospital Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain
  11. [11] Pulmonary Department, Hospital Universitario Son Llatzer, Palma de Mallorca, Spain
  12. [12] Pulmonary Department, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba, Universidad de Córdoba, Córdoba, Spain
  13. [13] Pulmonary Department, Hospital Universitario German Trias y Pujol, Barcelona, Spain
  14. [14] Pulmonary Department, Brigham and Women's Hospital, Boston, MA, United States

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• Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax ( ALAT ), ISSN 0300-2896, Vol. 60, Nº. 1, 2024, págs. 10-15
• Idioma: inglés
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  • Introduction The Global Lung Function Initiative (GLI) has proposed new criteria for airflow limitation (AL) and recommends using these to interpret spirometry. The objective of this study was to explore the impact of the application of the AL GLI criteria in two well characterized GOLD-defined COPD cohorts.

    Methods COPD patients from the BODE (n=360) and the COPD History Assessment In SpaiN (CHAIN) cohorts (n=722) were enrolled and followed. Age, gender, pack-years history, BMI, dyspnea, lung function measurements, exercise capacity, BODE index, history of exacerbations and survival were recorded. CT-detected comorbidities were registered in the BODE cohort. The proportion of subjects without AL by GLI criteria was determined in each cohort. The clinical, CT-detected comorbidity, and overall survival of these patients were evaluated.

    Results In total, 18% of the BODE and 15% of the CHAIN cohort did not meet GLI AL criteria. In the BODE and CHAIN cohorts respectively, these patients had a high clinical burden (BODE≥3: 9% and 20%; mMRC≥2: 16% and 45%; exacerbations in the previous year: 31% and 9%; 6MWD<350m: 15% and 19%, respectively), and a similar prevalence of CT-diagnosed comorbidities compared with those with GLI AL. They also had a higher rate of long-term mortality – 33% and 22% respectively.

    Conclusions An important proportion of patients from 2 GOLD-defined COPD cohorts did not meet GLI AL criteria at enrolment, although they had a significant burden of disease. Caution must be taken when applying the GLI AL criteria in clinical practice.