Detailed Information on Publication Record
2021
The Relation Between Clinical Phenotypes, GOLD Groups/Stages and Mortality in COPD Patients – A Prospective Multicenter Study
BRAT, Kristián, Michal SVOBODA, Jaromir ZATLOUKAL, Marek PLUTINSKÝ, Eva VOLAKOVA et. al.Basic information
Original name
The Relation Between Clinical Phenotypes, GOLD Groups/Stages and Mortality in COPD Patients – A Prospective Multicenter Study
Authors
BRAT, Kristián (703 Slovakia, guarantor, belonging to the institution), Michal SVOBODA (203 Czech Republic, belonging to the institution), Jaromir ZATLOUKAL (203 Czech Republic), Marek PLUTINSKÝ (703 Slovakia, belonging to the institution), Eva VOLAKOVA (203 Czech Republic), Patrice POPELKOVA (203 Czech Republic), Barbora NOVOTNA (203 Czech Republic), Tomas DVORAK (203 Czech Republic) and Vladmir KOBLIZEK (203 Czech Republic)
Edition
International Journal of Chronic Obstructive Pulmonary Disease, Albany, Dove Medical Press, 2021, 1178-2005
Other information
Language
English
Type of outcome
Článek v odborném periodiku
Field of Study
30203 Respiratory systems
Country of publisher
United States of America
Confidentiality degree
není předmětem státního či obchodního tajemství
References:
Impact factor
Impact factor: 2.893
RIV identification code
RIV/00216224:14110/21:00121546
Organization unit
Faculty of Medicine
UT WoS
000648310100001
Keywords in English
chronic obstructive pulmonary disease; COPD; phenotypes; mortality; cluster; classification and regression tree; CART
Tags
International impact, Reviewed
Změněno: 17/5/2022 09:11, Mgr. Tereza Miškechová
Abstract
V originále
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.
Links
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| 5/15/NAP, interní kód MU |
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