TY - JOUR T1 - Classification of COPD Patients According to ALAT and GOLD Staging Systems Using PUMA Study Data JO - Archivos de Bronconeumología T2 - AU - Montes de Oca,María AU - López Varela,María Victorina AU - Laucho-Contreras,María Eugenia AU - Casas,Alejandro AU - Schiavi,Eduardo AU - Rey,Alejandra AU - Silva,Alejandra SN - 15792129 M3 - 10.1016/j.arbr.2016.11.004 DO - 10.1016/j.arbr.2016.11.004 UR - https://archbronconeumol.org/en-classification-copd-patients-according-alat-articulo-S157921291630266X AB - IntroductionSeveral classification systems use different criteria when assessing COPD stages. The objective of this study was to compare the prevalence and distribution of COPD stages using Global initiative for chronic Obstructive Lung Disease (GOLD) recommendations and Latin American Thoracic Association (ALAT) guidelines in a primary-care population. MethodsSubjects attending routine primary care visits, ≥40 years of age, current or former smokers or exposed to biomass, completed a questionnaire and performed spirometry. COPD was defined as post-bronchodilator FEV1/FVC<0.70 and categorized according to GOLD-2013 criteria and ALAT-2014 guideline. The BODEx index was used to assess the prognostic value of the stratification systems. ResultsA total of 1743 subjects completed the interview, 1540 performed acceptable spirometry. COPD prevalence according to GOLD-2013 was 20.1% and had a U-shaped stage distribution (group A: 9.3%, B: 4.3%, C: 2.0%, D: 4.6%). According to ALAT, prevalence was 19.7% with a bell-shaped stage distribution (mild: 2.9%, moderate: 9%, severe: 5.4%, very-severe: 2.7%). Approximately 73% of patients were stratified as moderate (45.4%) or severe (27.3%) by ALAT guidelines, whereas using GOLD-2013 criteria the majority of subjects (approximately 69%) were in group A (46.3%) or group B (22.7%). BODE index score increased as COPD worsened according to ALAT stratification. This is not observed with GOLD-2013 criteria (similar values for B and C groups). ConclusionsDisease stages differ under ALAT and GOLD-2013 criteria. ALAT identified a greater proportion of COPD subjects in the moderate and severe categories compared with GOLD-2013, where the majority were categorized in group A. Future evaluation of the ALAT classification should address its predictive ability in terms of hospitalizations and mortality. ER -