Health Status in Patients with COPD According to GOLD 2017 Classification: Use of the COMCOLD Score in Routine Clinical Practice

COPD. 2018 Jun-Aug;15(4):326-333. doi: 10.1080/15412555.2018.1531388. Epub 2018 Nov 6.

Abstract

The COMCOLD score was developed to quantify the impact of comorbidities on health status in patients with chronic obstructive pulmonary disease (COPD). The objective of this study is to evaluate the association between health status in outpatients with COPD according to COMCOLD score and the GOLD 2017 groups according to symptoms (B and D vs. A and C) and exacerbations (C and D vs. A and B). 439 patients were included. The average score was 2.4 ± 3. 48% of cases had a COMCOLD score >0. The most symptomatic patients (B and D vs. A and C) had a higher score: 3 ± 3.3 vs. 1.3 ± 2.1 (p < 0.001), in contrast with the groups with a higher risk of exacerbation (C and D vs. A and B) in which there was no significant difference: 3 ± 3.5 vs. 2.2 ± 3.0 (p = 0.055). The most symptomatic patients (B and D) showed a greater prevalence of depression, peripheral artery disease and heart disease with an adjusted OR of 3.04 [CI95%: 1.36; 6.86], 2.49 [CI95%: 1.17; 5.29], and 4.41 [CI95%: 2.50; 7.75], respectively. Moreover, no relationship was found between the comorbidities defined by the COMCOLD score and the GOLD 2017 groups with the greatest risk of exacerbation (C and D). The greatest effect on health status was found in those patients with COPD belonging to the most symptomatic groups (B and D), with depression, peripheral artery disease, and heart disease being the main comorbidities involved.

Keywords: Chronic obstructive pulmonary disease; comorbidity; comorbidity index; health status; health-related quality of life; patient-reported outcome.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Comorbidity
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Disease Progression
  • Female
  • Forced Expiratory Volume
  • Health Status*
  • Heart Diseases / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Peripheral Arterial Disease / epidemiology
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Quality of Life
  • Spain / epidemiology
  • Vital Capacity