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Abstract：
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 report revised the combined assessment, merged the C and D groups into the E group, and revised the initial inhalation therapy recommendation.
This study aimed to analyze the future exacerbation and mortality of different inhalation therapies among patients with chronic obstructive pulmonary disease (COPD) in various groups based on the GOLD 2017 and GOLD 2023 reports.
This is a multicenter and retrospective study.
Stable COPD patients from the database setup by 12 hospitals were enrolled. The patients were divided into Groups A, B, C, D, and E according to the GOLD 2017 and GOLD 2023 reports. Then, the patients were classified into long-acting muscarinic antagonist (LAMA), long-acting β2-agonist (LABA) + inhaled corticosteroid (ICS), LABA + LAMA, and LABA + LAMA + ICS subgroups. Data on exacerbation and death during 1 year of follow-up were collected.
A total of 4623 patients were classified into Group A (15.0%), Group B (37.8%), Group C (7.3%), Group D (39.9%), and Group E (47.2%). The exacerbation, frequent exacerbation, and mortality showed no differences between different inhalation therapies in Groups A and C. Patients treated with LABA + LAMA or LABA + LAMA + ICS had a lower incidence of exacerbation and frequent exacerbation than patients treated with LAMA or LABA + ICS in Groups B, D, and E. The exacerbation, frequent exacerbation, and mortality showed no differences between different inhalation therapies after combining Groups A with C.
Patients in Group A should be recommended to undergo mono-LAMA, while patients in Groups B and E should be recommended treatment with LABA + LAMA, which is consistent with the GOLD 2023 report. However, it is worth considering merging Groups A and C into a single group and recommending mono-LAMA as the initial inhalation therapy.
This study aimed to analyze the future exacerbation and mortality of different inhalation therapies among patients with chronic obstructive pulmonary disease (COPD) in various groups based on the GOLD 2017 and GOLD 2023 reports.
This is a multicenter and retrospective study.
Stable COPD patients from the database setup by 12 hospitals were enrolled. The patients were divided into Groups A, B, C, D, and E according to the GOLD 2017 and GOLD 2023 reports. Then, the patients were classified into long-acting muscarinic antagonist (LAMA), long-acting β2-agonist (LABA) + inhaled corticosteroid (ICS), LABA + LAMA, and LABA + LAMA + ICS subgroups. Data on exacerbation and death during 1 year of follow-up were collected.
A total of 4623 patients were classified into Group A (15.0%), Group B (37.8%), Group C (7.3%), Group D (39.9%), and Group E (47.2%). The exacerbation, frequent exacerbation, and mortality showed no differences between different inhalation therapies in Groups A and C. Patients treated with LABA + LAMA or LABA + LAMA + ICS had a lower incidence of exacerbation and frequent exacerbation than patients treated with LAMA or LABA + ICS in Groups B, D, and E. The exacerbation, frequent exacerbation, and mortality showed no differences between different inhalation therapies after combining Groups A with C.
Patients in Group A should be recommended to undergo mono-LAMA, while patients in Groups B and E should be recommended treatment with LABA + LAMA, which is consistent with the GOLD 2023 report. However, it is worth considering merging Groups A and C into a single group and recommending mono-LAMA as the initial inhalation therapy.
摘要：
■2023年全球慢性阻塞性肺疾病倡议（GOLD）报告修订了合并评估，将C组和D组合并为E组，并修订了初始吸入治疗建议.
■本研究旨在根据GOLD2017和GOLD2023报告，分析不同组慢性阻塞性肺疾病（COPD）患者不同吸入疗法的未来恶化和死亡率。
■这是一项多中心的回顾性研究。
■纳入来自12家医院的数据库设置的稳定期COPD患者。患者分为A组,B,C,D,和E根据黄金2017和黄金2023报告。然后，患者被归类为长效毒蕈碱拮抗剂（LAMA），长效β2激动剂（LABA）+吸入皮质类固醇（ICS），LABA+LAMA,和LABA+LAMA+ICS亚组。收集1年随访期间的恶化和死亡数据。
■将4623例患者归入A组（15.0%），B组（37.8%），丙组(7.3%),D组（39.9%），和E组（47.2%）。恶化，频繁加重,A组和C组的不同吸入疗法之间的死亡率和死亡率没有差异。与B组的LAMA或LABA+ICS治疗的患者相比，接受LABA+LAMA或LABA+ICS治疗的患者加重和频繁加重的发生率较低，D,和E.恶化，频繁加重,A组和C组合并后，不同吸入疗法之间的死亡率无差异。
■A组患者应建议接受单LAMA治疗，而B组和E组的患者应推荐使用LABA+LAMA治疗，这与GOLD2023报告一致。然而,值得考虑将A组和C组合并为一组,并推荐单LAMA作为初始吸入治疗.
■本研究旨在根据GOLD2017和GOLD2023报告，分析不同组慢性阻塞性肺疾病（COPD）患者不同吸入疗法的未来恶化和死亡率。
■这是一项多中心的回顾性研究。
■纳入来自12家医院的数据库设置的稳定期COPD患者。患者分为A组,B,C,D,和E根据黄金2017和黄金2023报告。然后，患者被归类为长效毒蕈碱拮抗剂（LAMA），长效β2激动剂（LABA）+吸入皮质类固醇（ICS），LABA+LAMA,和LABA+LAMA+ICS亚组。收集1年随访期间的恶化和死亡数据。
■将4623例患者归入A组（15.0%），B组（37.8%），丙组(7.3%),D组（39.9%），和E组（47.2%）。恶化，频繁加重,A组和C组的不同吸入疗法之间的死亡率和死亡率没有差异。与B组的LAMA或LABA+ICS治疗的患者相比，接受LABA+LAMA或LABA+ICS治疗的患者加重和频繁加重的发生率较低，D,和E.恶化，频繁加重,A组和C组合并后，不同吸入疗法之间的死亡率无差异。
■A组患者应建议接受单LAMA治疗，而B组和E组的患者应推荐使用LABA+LAMA治疗，这与GOLD2023报告一致。然而,值得考虑将A组和C组合并为一组,并推荐单LAMA作为初始吸入治疗.
