GOLD 2017 RAPORUNA GÖRE KOAH HASTALARININ EVRELERÝNDEKÝ DEÐÝÞÝMLER VE BRONKODÝLATÖR ÝLAÇ SEÇÝMÝ ÜZERÝNE ETKÝSÝ

Amaç: GOLD 2017 kriterlerine göre KOAH hastalarýnýn ABCD evresindeki deðiþiklik oranýný araþtýrmayý ve bu deðiþikliklerin tedavide bronkodilatör ilaç seçimine etkisini deðerlendirmeyi amaçladýk. Yöntem ve Gereç: Çalýþmaya Þubat 2017 - Mayýs 2017 tarihleri arasýnda KOAH tanýsý ile polikliniðe baþvuran 100 hasta dahil edildi. GOLD 2011 ve 2017’deki sýnýflama kriterleri kullanýlarak hastalar sýnýflandýrýldý. Bunun için yýllýk alevlenme sayýsý, dispne skorlamasý, FEV1 % düzeyi deðerlendirildi. Hastalar söz konusu kriterler kullanýlarak ABCD sýnýflamasýna uygun þekilde gruplandýrýldý. Her gruptaki hastalarýn kullandýðý ve halen kullanmakta olduðu ilaçlar kaydedildi. Bulgular: Sýnýflandýrmada FEV1 deðerini içeren GOLD'a göre, A, B, C ve D evrelerinde KOAH hastalarýnýn oraný sýrasýyla% 8,% 10,% 14,% 68 idi. GOLD 2017 güncellemesine göre (FEV1 deðeri olmayan), hastalarýn evreleri sýrasýyla% 19,% 30,% 2 ve% 49 idi. Ýki sýnýflama arasýnda istatistiksel olarak anlamlý bir fark bulundu (p: 0,002). Evreleme sistemindeki FEV1 deðerini içeren sýnýflamaya göre tedavi seçiminde, iki evreleme sistemi arasýndaki tedavi seçimleri için istatistiksel olarak anlamlý bir fark vardý (p: 0.000). Sonuç: Bu çalýþma, GOLD 2017 güncellemesine göre D ve C gruplarýnda hasta sayýsýnýn azalmasýna baðlý olarak kombine preparatlarýn (özellikle inhale steroidlerin) kullanýmýnýn azaldýðýný ve LAMA veya LABA ile monoterapinin arttýðýný göstermiþtir.

CHANGES IN THE STAGES OF COPD PATIENTS AND EFFECT ON BRONCHODILATOR DRUG SELECTION ACCORDING TO GOLD 2017 REPORT

Aim: We aimed to investigate the rate of changes in ABCD stages of COPD patients according to GOLD 2017 criteria and also to evaluate the effect of these changes on bronchodilator drug selection in treatment.Material and method: One hundred patients who were admitted to the outpatient clinic with a diagnosis of COPD between February 2017 and May 2017 were included in the study. Patients were classified using the classification criteria in GOLD 2011 and 2017. For this reason, the number of exacerbations, dyspnea score, FEV1% level were evaluated. Patients were grouped according to ABCD classification using these criteria. Medications used by patients in each group and currently using drugs were recorded. Results: According to the GOLD that includes FEV1 value in classification, the rate of COPD patients in the A, B, C, and D stages was 8%, 10%, 14%, 68%, respectively. According to GOLD 2017 update (without FEV1 value), the stages of patients were 19%, 30%, 2% and 49%, respectively. A statistically significant difference was found between the two classifications (p: 0.002). In the selection of treatment according to classification that includes FEV1 value in staging system, there was a statistically significant difference for treatment selections between the two staging systems (p:0.000). Conclusion: This study showed that the use of combined preparations (especially inhaled steroids) in treatment decreased due to the decrease of the number of patients in D and C groups according to GOLD 2017 update, and the monotherapy with LAMA or LABA increased.