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

Figures & data

Figure 1. Charlson Comorbidity Index score according to GOLD 2017 categories. The figure illustrates Box and Whiskers plots: the big square represents the median and small square represents mean ± standard deviation.

Table 1. Characteristics of the population with chronic obstructive pulmonary disease.

Variable	Global n = 439
Age, years (mean ± SD)	69 ± 9.8
Sex (male %)	78.8
BMI (mean ± SD)	28.3 ± 6
Current smoker (%)	35
Pack-years index (mean ± SD)	46 ± 24
Charlson index (mean ± SD)	2.5 ± 1.5
Age-adjusted Charlson index (mean ± SD)	5.2 ± 2.1
FEV1, % (mean ± SD)	55 ± 20
FEV1, L (mean ± SD)	1.48 ± 0.67
FVC, % (mean ± SD)	83 ± 21
FVC, L (mean ± SD)	2.79 ± 0.90
FEV1/FVC (mean ± SD)	51 ± 12
GOLD 2009 grades (%) I/II/III/IV	13/42/36/9
GOLD 2017 categories (%) A/B/C/D	32/48/2/18
COMCOLD score (median[P25–P75])	0 (0–3)
COMCOLD score (mean ± SD)	2.4 ± 3
COMCOLD score >0 (% per GOLD 2017), A/B/C/D	31/56/40/57

SD: standard desviation; FEV₁: maximum volume exhaled in the first second; FVC: forced vital capacity; GOLD: Global Initiative for Chronic Obstructive Lung Disease; BMI: body mass index (kg/m₂); L: litres

Table 2. Prevalence and crude/adjusted odds ratios for comorbidities in relation to GOLD 2017.

Comorbidity	Prevalence (%)	B and D vs. A and C	C and D vs. A and B	B and D vs. A and C	C and D vs. A and B
		Crude OR		Adjusted OR
COMCOLD comorbidities
Depression	12.5 [9.6; 16.0]	3.20*** [1.45; 7.07]	1.33 [0.69; 2.55]	3.04*** [1.36; 6.86]	1.27 [0.65; 2.47]
Anxiety	7.5 [5.2; 10.4]	1.81 [0.75; 4.38]	1.53 [0.68; 3.42]	1.86 [0.75; 4.58]	1.57 [0.68; 3.60]
Peripheral artery disease	11.2 [8.4; 14.5]	2.31* [1.11; 4.84]	0.70 [0.32; 1.53]	2.49* [1.17; 5.29]	0.76 [0.34; 1.70]
Cerebrovascular disease	7.3 [5.0; 10.1]	1.34 [0.57; 3.16]	2.01† [0.91; 4.47]	1.41 [0.59; 3.40]	2.14 [0.94; 4.90]
Symptomatic heart disease	26.7 [22.6; 31.1]	3.35*** [1.95; 5.75]	0.86 [0.50; 1.46]	4.41*** [2.50; 7.75]	1.14 [0.65; 2.01]
Heart failure	16.2 [12.9; 20.0]	2.72** [1.42; 5.21]	0.82 [0.44; 1.56]	3.34** [1.71; 6.50]	0.95 [0.54; 2.04]
Coronary heart disease	14.4 [11.2; 18.0]	3.60*** [1.70; 7.60]	0.95 [0.50; 1.81]	4.47** [2.08; 9.60]	1.24 [0.62; 2.45]
Other comorbidities
Dyslipidemia	67.2 [62.6; 71.6]	1.61* [1.04; 2.48]	0.62^† [0.37; 1.02]	2.21*** [1.38; 3.54]	0.78 [0.46; 1.31]
Hypertension	66.1 [61.4; 70.5]	1.97** [1.27; 3.03]	0.58* [0.35; 0.96]	2.71*** [1.69; 4.33]	0.73 [0.43; 1.24]
Obesity (BMI ≥30)	38.5% [33.9; 43.2]	1.41 [0.90; 2.19]	0.43** [0.24; 0.77]	1.90** [1.19; 3.05]	0.58 [0.31; 1.05]
Diabetes	32.6 [28.2; 37.2]	1.84** [1.17; 2.89]	0.78 [0.47; 1.30]	2.50*** [1.54; 4.05]	1.06 [0.61; 1.85]
Sleep apnea	23.9 [20.0; 28.2]	1.22 [0.76; 1.96]	0.40** [0.21; 0.78]	1.88* [1.12; 3.18]	0.63 [0.31;1.31]
Asthma	22.6 [18.7; 26.8]	1.17 [0.71; 1.94]	1.69^† [0.99; 2.89]	1.16 [0.69; 1.96]	1.69 [0.98; 2.93]
Arrhythmia	20.3 [16.6; 24.3]	2.32** [1.32; 4.1]	0.89 [0.49; 1.63]	2.74*** [1.53; 4.89]	0.87 [0.46; 1.62]
Chronic kidney disease	12.8 [9.8; 16.3]	2.51* [1.24; 5.07]	0.66 [0.31; 1.38]	2.96** [1.44; 6.07]	0.80 [0.37; 1.72]
Tumor	10.9 [8.2; 14.2]	0.96 [0.50; 1.86]	1.35 [0.66; 2.79]	0.83 [0.49; 1.66]	1.20 [0.57; 2.53]
Pulmonary	3.2 [1.8; 3.2]	1.62 [0.42; 6.16]	1.97 [0.62; 6.26]	1.54 [0.39; 6.13]	1.92 [0.58; 6.37]
Extrapulmonary	7.7 [5.4; 10.7]	0.80 [0.38; 1.70]	1.07 [0.44; 2.63]	0.68 [0.31; 1.49]	0.93 [0.37; 2.32]
Liver disease	8.2 [5.8; 11.2]	1.04 [0.46; 2.04]	1.34 [0.59; 3.05]	1.09 [0.51; 2.36]	1.57 [0.67; 3.68]
Osteoporosis	3.6 [2.1; 5.9]	1.90 [0.51; 7.05]	2.07 [0.71; 6.06]	1.86 [0.48; 7.18]	2.07 [0.68; 6.29]

^† p < 0.100.

* p < 0.050.

** p < 0.010.

*** p < 0.001.

GOLD: Global Initiative for Chronic Obstructive Lung Disease; BMI: body mass index (kg/m2); OR: odds ratio.

Figure 2. COMCOLD score according to GOLD 2017 categories. The figure illustrates Box and Whiskers plots: the big square represents the median and small square represents mean ± standard deviation.