ABSTRACT BACKGROUND: The new GOLD update includes airflow limitation, history of COPD exacerbations and symptoms to classify and grade COPD severity. We aimed to determine their distribution in eleven, well defined COPD cohorts, and their prognostic validity up to 10 years to predict time to death. METHODS: Spirometry in all eleven cohors was post-bronchodilator. Survival analysis and C-statistics were used to compare the two GOLD systems by varying time points. RESULTS: Of 3,633 patients, 1,064 (33.6%) were in new GOLD patient group A (low risk, less symptoms); 515 (16.3%) were B (low risk, more symptoms); 561 (17.7%) were C (high risk, less symptoms); and 1,023 (32.3%) were D (high risk, more symptoms). There was great heterogeneity of this distribution within the cohorts (Chi2 p value < 0.01). No differences were seen in the C statistics of old versus new GOLD grading to predict mortality at one year (0.635 vs. 0.639, p=0.53, at three years (0.637 vs. 0.645, p=0.21) or at 10 years (0.639 vs. 0.642, p=0.76). CONCLUSIONS: The new GOLD grading produces an uneven split of the COPD population, one third each in A and D patient groups, and its prognostic validity to predict time to death is no different than the old GOLD staging based in spirometry only.1Fundación Caubet-Cimera Illes Balears, Bunyola, Spain; 2Hospital Universitario Valme, Sevilla; 3Internal Medicine, Hospital Universitari Mutua de Terrassa, Universitat de Barcelona, Barcelona; 4Hospital Nuestra Señora de la Candelaria, Tenerife; 5Hospital Galdakao-Usansolo, Galdakao, Bizkaia 6Unidad de Neumología, Servicio de Medicina Interna, Hospital General de Requena, Valencia; 7Clınica Universidad de Navarra, Pamplona; 8CAIBER, Oficina de Investigación Biosanitaria de Asturias, Oviedo; 9Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain; 10Harvard University, Brigham and Women's Hospital, Pulmonary and Critical Care Medicine, Boston, MA, USA; 11Hospital Universitario Miguel Servet, Zaragoza, SpainAuthor for correspondence: Dr. Joan B Soriano Director, Program of Epidemiology & Clinical Research CIMERA. Recinte Hospital Joan March, Carretera Soller Km 12. 07110 - Bunyola, Illes Balears; Spain Email: jbsoriano@caubet-cimera.esFINANCIAL DISCLOSURE INFORMATION: No funding was required/available for COCOMICS.