de-Torres, Juan P.Marín, Jose M.Pinto-Plata, VíctorDivo, MiguelSanchez-Salcedo, PabloZagaceta, JorgeZulueta, Javier J.Berto, JuanCabrera, CarlosCelli, BartolomeCasanova, Ciro2016-05-022016de-Torres, J. P., J. M. Marín, V. Pinto-Plata, M. Divo, P. Sanchez-Salcedo, J. Zagaceta, J. J. Zulueta, et al. 2016. “Is COPD a Progressive Disease? A Long Term Bode Cohort Observation.” PLoS ONE 11 (4): e0151856. doi:10.1371/journal.pone.0151856. http://dx.doi.org/10.1371/journal.pone.0151856.1932-6203http://nrs.harvard.edu/urn-3:HUL.InstRepos:26860322Background: The Global Initiative for Obstructive Lung Diseases (GOLD) defines COPD as a disease that is usually progressive. GOLD also provides a spirometric classification of airflow limitation. However, little is known about the long-term changes of patients in different GOLD grades. Objective: Explore the proportion and characteristics of COPD patients that change their spirometric GOLD grade over long-term follow-up. Methods: Patients alive for at least 8 years since recruitment and those who died with at least 4 years of repeated spirometric measurements were selected from the BODE cohort database. We purposely included the group of non survivors to avoid a “survival selection” bias. The proportion of patients that had a change (improvement or worsening) in their spirometric GOLD grading was calculated and their characteristics compared with those that remained in the same grade. Results: A total of 318 patients were included in the survivor and 217 in the non-survivor groups. Nine percent of survivors and 11% of non survivors had an improvement of at least one GOLD grade. Seventy one percent of survivors and non-survivors remained in the same GOLD grade. Those that improved had a greater degree of airway obstruction at baseline. Conclusions: In this selected population of COPD patients, a high proportion of patients remained in the same spirometric GOLD grade or improved in a long-term follow-up. These findings suggest that once diagnosed, COPD is usually a non-progressive disease.en-USMedicine and Health SciencesPulmonologyChronic Obstructive Pulmonary DiseaseBiology and Life SciencesPhysiologyPhysiological PropertiesPhysiological ParametersBody WeightBody Mass IndexBioassays and Physiological AnalysisRespiratory AnalysisSpirometryPharmacologyClinical PharmacologyPathology and Laboratory MedicineProgressive DiseasesCardiovascular MedicineCardiovascular DiseasesDatabase and Informatics MethodsJournal Article2016-05-0210.1371/journal.pone.0151856