Journal article
FEV1/FVC Severity Stages for Chronic Obstructive Pulmonary Disease
American journal of respiratory and critical care medicine, Vol.208(6), pp.676-684
09/15/2023
DOI: 10.1164/rccm.202303-0450OC
PMCID: PMC10515563
PMID: 37339502
Abstract
RATIONALE The diagnosis of COPD is based on low ratio of the forced expiratory volume in one second to the forced vital capacity (FEV1/FVC) but its severity is classified using percentage predicted FEV1 (ppFEV1). OBJECTIVE To test a new severity classification scheme for COPD using FEV1/FVC, a more robust measure of airflow obstruction than ppFEV1. METHODSI n COPDGene (n=10,132), the severity of airflow obstruction was categorized by GOLD Stages I-IV (ppFEV1 ≥80, ≥50-80, ≥30-50, and <30). A new severity classification (STaging of Airflow obstruction by Ratio, STAR) was tested in COPDGene: FEV1/FVC ≥0.60 to <0.70, ≥0.50 to <0.60, ≥0.40 to <0.50, and <0.40, respectively for stages I-IV, and applied to the combined Pittsburgh SCCOR and Pittsburgh Emphysema registry cohorts for replication (n=2017). MEASUREMENTS AND MAIN RESULTS Agreement (weighted Bangdiwala B) between GOLD and new FEV1/FVC severity stages was 0.89 in COPDGene and 0.88 in the Pittsburgh cohort. In both COPDGene and the Pittsburgh cohort, in comparison to GOLD staging, STAR provided significant discrimination between the absence of airflow obstruction and Stage I for all-cause mortality, respiratory-quality of life, dyspnea, airway wall thickness, exacerbations and lung function decline. No difference was noted for emphysema, small airways disease, and 6-minute walk distance. The STAR classification system identified a greater number of adults with Stage III-IV disease who would be eligible for lung transplantation and lung volume reduction evaluations. CONCLUSIONSThe new severity classification scheme STAR provides discrimination for mortality similar to the GOLD classification but with a more uniform gradation of disease truncated.
Details
- Title: Subtitle
- FEV1/FVC Severity Stages for Chronic Obstructive Pulmonary Disease
- Creators
- Surya P Bhatt - University of Alabama at BirminghamArie Nakhmani - University of Alabama at BirminghamSpyridon Fortis - University of IowaMatthew J Strand - National Jewish HealthEdwin K Silverman - Brigham and Women's HospitalFrank C Sciurba - University of PittsburghSandeep Bodduluri - University of Alabama at Birmingham
- Resource Type
- Journal article
- Publication Details
- American journal of respiratory and critical care medicine, Vol.208(6), pp.676-684
- DOI
- 10.1164/rccm.202303-0450OC
- PMID
- 37339502
- PMCID
- PMC10515563
- NLM abbreviation
- Am J Respir Crit Care Med
- eISSN
- 1535-4970
- Grant note
- DOI: 10.13039/100000002, name: NIH, award: R01 HL151421, UH3HL155806, K01HL163249, P50 HL084948, R01 HL159805-05A1, R01 HL157879-01, U01 HL089897, U01 HL089856
- Language
- English
- Electronic publication date
- 06/20/2023
- Date published
- 09/15/2023
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984436455602771
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