Validation of Clinical COPD Phenotypes for Prognosis of Long-Term Mortality in Swedish and Dutch Cohorts

Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with variable mortality risk. The aim of our investigation was to validate a simple clinical algorithm for long-term mortality previously proposed by Burgel et al. in 2017. Subjects with COPD from two cohorts, the Swedish PRAXIS study (n = 784, mean age (standard deviation (SD)) 64.0 years (7.5), 42% males) and the Rotterdam Study (n = 735, mean age (SD) 72 years (9.2), 57% males), were included. Five clinical clusters were derived from baseline data on age, body mass index, dyspnoea grade, pulmonary function and comorbidi... Mehr ...

Verfasser: S. Gagatek
S. R. A. Wijnant
B. Ställberg
K. Lisspers
G. Brusselle
X. Zhou
M. Hasselgren
S. Montgomeryi
J. Sundhj
C. Janson
Ö. Emilsson
L. Lahousse
A. Malinovschi
Dokumenttyp: Artikel
Erscheinungsdatum: 2022
Reihe/Periodikum: COPD, Vol 19, Iss 1, Pp 330-338 (2022)
Verlag/Hrsg.: Taylor & Francis Group
Schlagwörter: copd / phenotypes / mortality / comorbidities / epidemiology / Diseases of the respiratory system / RC705-779
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-28989448
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://doi.org/10.1080/15412555.2022.2039608

Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with variable mortality risk. The aim of our investigation was to validate a simple clinical algorithm for long-term mortality previously proposed by Burgel et al. in 2017. Subjects with COPD from two cohorts, the Swedish PRAXIS study (n = 784, mean age (standard deviation (SD)) 64.0 years (7.5), 42% males) and the Rotterdam Study (n = 735, mean age (SD) 72 years (9.2), 57% males), were included. Five clinical clusters were derived from baseline data on age, body mass index, dyspnoea grade, pulmonary function and comorbidity (cardiovascular disease/diabetes). Cox models were used to study associations with 9-year mortality. The distribution of clinical clusters (1–5) was 29%/45%/8%/6%/12% in the PRAXIS study and 23%/26%/36%/0%/15% in the Rotterdam Study. The cumulative proportion of deaths at the 9-year follow-up was highest in clusters 1 (65%) and 4 (72%), and lowest in cluster 5 (10%) in the PRAXIS study. In the Rotterdam Study, cluster 1 (44%) had the highest cumulative mortality and cluster 5 (5%) the lowest. Compared with cluster 5, the meta-analysed age- and sex-adjusted hazard ratio (95% confidence interval) for cluster 1 was 6.37 (3.94–10.32) and those for clusters 2 and 3 were 2.61 (1.58–4.32) and 3.06 (1.82–5.13), respectively. Burgel’s clinical clusters can be used to predict long-term mortality risk. Clusters 1 and 4 are associated with the poorest prognosis, cluster 5 with the best prognosis and clusters 2 and 3 with intermediate prognosis in two independent cohorts from Sweden and the Netherlands. Supplemental data for this article is available online at https://doi.org/10.1080/15412555.2022.2039608 .