Figure 1

Study flow chart. COPD Chronic obstructive pulmonary disease, GOLD Global Initiative for Chronic Obstructive Lung Disease. D1: Forced expiratory volume in one second (FEV1) < 50% predicted and fewer than two exacerbations (and < 1 hospitalized exacerbation) in the previous year. D2: FEV1 ≥ 50% predicted and two or more exacerbations (or ≥ 1 hospitalized exacerbation ) in the previous year. D3: FEV1 < 50% predicted and two or more exacerbations (or ≥ 1 hospitalized exacerbation) in the previous year.