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@article{1766198,
author = {Brat, Kristián and Svoboda, Michal and Zatloukal, Jaromir and Plutinský, Marek and Volakova, Eva and Popelkova, Patrice and Novotna, Barbora and Dvorak, Tomas and Koblizek, Vladmir},
article_location = {Albany},
article_number = {April 2021},
doi = {http://dx.doi.org/10.2147/COPD.S297087},
keywords = {chronic obstructive pulmonary disease; COPD; phenotypes; mortality; cluster; classification and regression tree; CART},
language = {eng},
issn = {1178-2005},
journal = {International Journal of Chronic Obstructive Pulmonary Disease},
title = {The Relation Between Clinical Phenotypes, GOLD Groups/Stages and Mortality in COPD Patients – A Prospective Multicenter Study},
url = {https://www.dovepress.com/the-relation-between-clinical-phenotypes-gold-groupsstages-and-mortali-peer-reviewed-fulltext-article-COPD},
volume = {16},
year = {2021}
}
TY - JOUR
ID - 1766198
AU - Brat, Kristián - Svoboda, Michal - Zatloukal, Jaromir - Plutinský, Marek - Volakova, Eva - Popelkova, Patrice - Novotna, Barbora - Dvorak, Tomas - Koblizek, Vladmir
PY - 2021
TI - The Relation Between Clinical Phenotypes, GOLD Groups/Stages and Mortality in COPD Patients – A Prospective Multicenter Study
JF - International Journal of Chronic Obstructive Pulmonary Disease
VL - 16
IS - April 2021
SP - 1171-1182
EP - 1171-1182
PB - Dove Medical Press
SN - 11782005
KW - chronic obstructive pulmonary disease
KW - COPD
KW - phenotypes
KW - mortality
KW - cluster
KW - classification and regression tree
KW - CART
UR - https://www.dovepress.com/the-relation-between-clinical-phenotypes-gold-groupsstages-and-mortali-peer-reviewed-fulltext-article-COPD
N2 - Introduction: The concept of phenotyping emerged, reflecting specific clinical, pulmonary and extrapulmonary features of each particular chronic obstructive pulmonary disease (COPD) case. Our aim was to analyze prognostic utility of: “Czech“ COPD phenotypes and their most frequent combinations, ”Spanish” phenotypes and Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages + groups in relation to long-term mortality risk. Methods: Data were extracted from the Czech Multicenter Research Database (CMRD) of COPD. Kaplan-Meier (KM) estimates (at 60 months from inclusion) were used for mortality assessment. Survival rates were calculated for the six elementary “Czech” phenotypes and their most frequent and relevant combinations, “Spanish” phenotypes, GOLD grades and groups. Statistically significant differences were tested by Log Rank test. An analysis of factors underlying mortality risk (the role of confounders) has been assessed with the use of classification and regression tree (CART) analysis. Basic factors showing significant differences between deceased and living patients were entered into the CART model. This showed six different risk groups, the differences in risk were tested by a Log Rank test. Results: The cohort (n=720) was 73.1% men, with a mean age of 66.6 years and mean FEV1 44.4% pred. KM estimates showed bronchiectases/COPD overlap (HR 1.425, p=0.045), frequent exacerbator (HR 1.58, p< 0.001), cachexia (HR 2.262, p< 0.001) and emphysematous (HR 1.786, p=0.015) phenotypes associated with higher mortality risk. Co-presence of multiple phenotypes in a single patient had additive effect on risk; combination of emphysema, cachexia and frequent exacerbations translated into poorest prognosis (HR 3.075; p< 0.001). Of the “Spanish” phenotypes, AE CB and AE non-CB were associated with greater risk of mortality (HR 1.787 and 2.001; both p=0.001). FEV1% pred., cachexia and chronic heart failure in patient history were the major underlying factors determining mortality risk in our cohort. Conclusion: Certain phenotypes (“Czech” or “Spanish”) of COPD are associated with higher risk of death. Co-presence of multiple phenotypes (emphysematous plus cachectic plus frequent exacerbator) in a single individual was associated with amplified risk of mortality.
ER -
BRAT, Kristián, Michal SVOBODA, Jaromir ZATLOUKAL, Marek PLUTINSKÝ, Eva VOLAKOVA, Patrice POPELKOVA, Barbora NOVOTNA, Tomas DVORAK and Vladmir KOBLIZEK. The Relation Between Clinical Phenotypes, GOLD Groups/Stages and Mortality in COPD Patients – A Prospective Multicenter Study. \textit{International Journal of Chronic Obstructive Pulmonary Disease}. Albany: Dove Medical Press, 2021, vol.~16, April 2021, p.~1171-1182. ISSN~1178-2005. Available from: https://dx.doi.org/10.2147/COPD.S297087.
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