ArticleJournal of global health2025
Prognostic risk profiling in COPD using Global Initiative for Chronic Obstructive Lung Disease 2023 ABE and comorbidity assessment: evidence from a register-based COPD cohort.
Article in Journal of global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Estimation of mortality hazard ratios by COPD grade using a systematic review and network meta-analysis: deriving grade-, sex-, and age-specific mortality for a German COPD decision model.Scientific reports · 2026Pooled it
- The Disproportionate Burden of Cardiovascular Disease in Mild-to-Moderate COPD.International journal of chronic obstructive pulmonary disease · 2026Article
- From clinical phenotypes to cellular mechanisms: a precision medicine framework for COPD.Frontiers in immunology · 2026Review
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10 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: While the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 ABE classification system guides initial chronic obstructive pulmonary disease (COPD) treatment, patient heterogeneity and comorbidities complicate management. We investigated how the GOLD 2023 ABE classification and aligned comorbidity profiles affect patient outcomes in real-world Asian populations with COPD. Methods: We conducted a register-based cohort study of 38 928 patients from multiple institutions across Taiwan (from April 2017 to December 2021). We classified patients by GOLD 2023 ABE categories. Data included demographics, Charlson comorbidity index (CCI)-defined comorbidities, treatment, symptoms, questionnaires, spirometry, and outcomes. Results: Among COPD patients, 89.2% were males, and the median age was 71 years. Groups A comprised 30.2%, group B 46.4%, and group E 23.5% of patients. Among these, 28.3% of group A patients used inhaled corticosteroid-containing inhalers. Group E had the highest rates of GOLD 4 airway obstruction (11.8%), CCI score ≥4 (15.6%), and five-year mortality rate (22.6%). Group E demonstrated the highest risk of all-cause mortality (hazard ratio (HR) = 1.727; 95% confidence interval (CI) = 1.605-1.858) and moderate-to-severe exacerbation (HR = 2.127; 95% CI = 1.942-2.330) vs. group A. Key comorbidities, acute myocardial infarction (HR = 1.257; 95% CI = 1.057-1.430), congestive heart failure (HR = 1.836; 95% CI = 1.707-1.909), and pulmonary disease (HR = 1.071; 95% CI = 1.011-1.129), were associated with higher mortality. Acute myocardial infarction (HR = 1.251; 95% CI = 1.031-1.444), congestive heart failure (HR = 1.193; 95% CI = 1.089-1.285), and pulmonary disease (HR = 1.491; 95% CI = 1.405-1.550) were also associated with higher exacerbations, with patterns varying across GOLD groups. Conclusions: In this large registry-based cohort, group E patients demonstrated the highest mortality and exacerbation risks. Cardiovascular and pulmonary comorbidities increased adverse outcome risks across all GOLD categories. Systematic comorbidity screening should be integrated into routine COPD care. Findings support personalised treatment approaches based on GOLD classification and comorbidity profiles.
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