Prognostic Validation Using GesEPOC 2017 Severity Criteria

The Spanish COPD guidelines (GesEPOC) have been recently modified. The aim of this study is to assess this revision and evaluate the prognosis of patients according to the new classification of severity.

A total of 700 COPD patients (83.9% men) were prospectively followed up for a mean period of 5 years in tertiary hospitals in Spain and the USA. Anthropometric data, lung function tests, dyspnea (according to the mMRC scale), BODE and Charlson index were collected. We calculated mortality at 5 years following the risk criteria proposed by the new GesEPOC.

Mean age was 66±9.6 years and mean FEV₁% was 59.7±20.2. The proportion of patients in the low-risk group was 40.43%. Patients in the high-risk group had a significantly higher BODE index than those in the low-risk group (2.92±0,66 vs. 0.52±1.91, p<0.001), while the Charlson index score was similar in both groups. Mortality at 60 months was significantly higher in the high-risk group (31.7% vs. 15.5%, p<0.001). Dyspnea and FEV₁% were also independent predictors of mortality (p<0.001), and neither was inferior to the risk classification proposed by GesEPOC.

The new severity index proposed by GesEPOC accurately predicts 5-year mortality. However, dyspnea and FEV₁% have the same strength in predicting mortality.