Introduction: Since GOLD 2017 separates spirometry results from ‘ABCD’ groups, there have been some changes to the stages of COPD patients. Our aim was to investigate the shifts in COPD groups after GOLD 2017.

Methods: COPD patients from outpatient clinics of 3 hospitals in Turkey were stratified into old and new ABCD groups according to exacerbation history, mMRC evaluation and spirometry results for both GOLD 2011 and 2017 assessments. Treatment protocols were also evaluated if they were suitable for both classifications.

Results: There were 578 patients (334 men, 244 women) with a mean age of 65.21±10.42. The distribution of patients from group A to D was 28%, 15%, 15%, 42% (GOLD 2011) and 36%, 22%, 7% and 35% (GOLD 2017) respectively. There were shifts from group C to A (53.4%) and D to B (18.4%). The treatment suitability was 66.3% in GOLD 2011 and 60.9% in GOLD 2017. The most common inappropriate treatment protocol was triple therapy. Presence of exacerbations in last year, mMRC score, FEV1 level (p < 0.01 for three parameters) and proportion of males (p = 0.029) were statistically significantly higher in groups C and D of GOLD 2017 compared with new patients in group A and B of GOLD 2017 (shifted from GOLD 2011's C-D groups).

Conclusion: There were shifts from group C to A and D to B with GOLD 2017, which means some high-risk COPD patients were reclassified into low-risk groups. Despite guideline updates, there are still many COPD patients with overtreatment. To our knowledge, this is the first study examining transitions between COPD groups after GOLD 2017 in Turkey.

简介：自 GOLD 2017 将肺活量测定结果与“ABCD”组分开以来，COPD 患者的分期发生了一些变化。我们的目的是调查 GOLD 2017 之后 COPD 组的变化。

方法：根据急性加重史、mMRC 评估和 GOLD 2011 和 2017 评估的肺活量测定结果，将土耳其 3 家医院门诊的 COPD 患者分为新旧 ABCD 组。还评估了治疗方案是否适用于两种分类。

结果：578例患者（334名男性，244名女性），平均年龄为65.21±10.42岁。从 A 组到 D 组的患者分布分别为 28%、15%、15%、42%（GOLD 2011）和 36%、22%、7% 和 35%（GOLD 2017）。有从 C 组到 A (53.4%) 和 D 到 B (18.4%) 的转变。GOLD 2011 中的治疗适用性为 66.3%，GOLD 2017 中为 60.9%。最常见的不适当治疗方案是三联疗法。与 A 组和 B 组的新患者相比，GOLD 2017 的 C 组和 D 组去年的急性加重、mMRC 评分、FEV1 水平（三个参数 p < 0.01）和男性比例（p = 0.029）在统计学上显着更高的 GOLD 2017（从 GOLD 2011 的 CD 组转移）。

结论：GOLD 2017 发生了从 C 组到 A 组和 D 组到 B 组的转变，这意味着一些高危 COPD 患者被重新分类为低危组。尽管指南有所更新，但仍有许多 COPD 患者过度治疗。据我们所知，这是在 2017 年土耳其 GOLD 之后首次研究 COPD 组之间的转变。