Comparative study assessing a group of COPD patients according to the new combined (ABCD) assessment tool in Al-Yarmouk Teaching Hospital

Abstract

List of abbreviations

DLCO : diffusion capacity of Carbon monoxide

GOLD : global initiative of chronic obstructive pulmonary disease

FEV1 : forced expiratory volume in first second

FVC : forced vital capacity

ICS : inhaled corticosteroid

LABA : long acting beta agonist

LAMA : long acting anti muscarinic

mMRC modified medical research council

SABA : short acting beta agonist

SAMA : short acting anti muscarinic

ABSTRACT

Background: COPD is one of the commonest respiratory illnesses that lead great morbidity and disability and one of the leading causes of mortality worldwide, also it is a growing field of researches regarding reclassification and treatment review there are several methods of classification of COPD patients: GOLD system and the newer ABCD assessment tool which is the main field of this research.

Objective: The aim of the study is to evaluate the patients with COPD using the new ABCD assessment tool and comparing it with GOLD classification system in the way of early detection and diagnosis of COPD.

Patients and methods: A cross-sectional study was conducted at Al-Yarmouk Teaching Hospital - Department of Respiratory medicine involving 110 COPD patient evaluated depending on history , physical examination , radiological imaging , spirometry and six minute walk test. Then the patients had been grouped according to GOLD and ABCD classification systems then comparism between two modalities had been done.

Results: The study involved 110 patients aged between 42 and 81 years old ; 92 male and 18 female, male : female ratio 5:1.

We assess the patients according to GOLD module, then the patient had been redistributed according  to ABCD assessment tool using FEV1, dyspnea scale utilizing mMRC , and number of exacerbation per year reveal the following: No  patient (0%) GOLD 1, 36 patient (32.7%) GOLD2, 42 patient (38.2%) GOLD3, and 32 patient (29.1%) GOLD 4 ; while  redistributing the patients according to ABCD module reveals the following: Twenty seven patient (24.5%) were class A, 10 patients (9%) were class B , 6 patients (5.5%) class C  and 67 patient (61%) of class D ; so there is a significant difference between the different categories of ABCD assessment tool as compared to GOLD groups due to the impact of dyspnea scale and number of exacerbations on the reclassification.

Conclusions: ABCD assessment tool may be more accurate and practical than GOLD classification ; ABCD assessment tool can be of benefit in early detection and management of early COPD cases more than the GOLD system.

Recommendations: utilization of ABCD assessment tool in early detection , diagnosis , and follow up of patients with COPD.