A simple algorithm for the identification of clinical COPD phenotypes
Por:
Burgel PR, Paillasseur JL, Janssens W, Piquet J, Ter Riet G, Garcia-Aymerich J, Cosio B, Bakke P, Puhan MA, Langhammer A, Alfageme I, Almagro P, Ancochea J, Celli BR, Casanova C, de-Torres JP, Decramer M, Echazarreta A, Esteban C, Gomez Punter RM, Han MK, Johannessen A, Kaiser B, Lamprecht B, Lange P, Leivseth L, Marin JM, Martin F, Martinez-Camblor P, Miravitlles M, Oga T, Sofia Ramírez A, Sin DD, Sobradillo P, Soler-Cataluña JJ, Turner AM, Verdu Rivera FJ, Soriano JB, Roche N and Initiatives BPCO, E
Publicada:
1 nov 2017
Resumen:
This study aimed to identify simple rules for allocating chronic obstructive pulmonary disease (COPD) patients to clinical phenotypes identified by cluster analyses.
Data from 2409 COPD patients of French/Belgian COPD cohorts were analysed using cluster analysis resulting in the identification of subgroups, for which clinical relevance was determined by comparing 3-year all-cause mortality. Classification and regression trees (CARTs) were used to develop an algorithm for allocating patients to these subgroups. This algorithm was tested in 3651 patients from the COPD Cohorts Collaborative International Assessment (3CIA) initiative.
Cluster analysis identified five subgroups of COPD patients with different clinical characteristics (especially regarding severity of respiratory disease and the presence of cardiovascular comorbidities and diabetes). The CART-based algorithm indicated that the variables relevant for patient grouping differed markedly between patients with isolated respiratory disease (FEV1, dyspnoea grade) and those with multi-morbidity (dyspnoea grade, age, FEV1 and body mass index). Application of this algorithm to the 3CIA cohorts confirmed that it identified subgroups of patients with different clinical characteristics, mortality rates (median, from 4% to 27%) and age at death (median, from 68 to 76 years).
A simple algorithm, integrating respiratory characteristics and comorbidities, allowed the identification of clinically relevant COPD phenotypes.
Filiaciones:
Burgel PR:
University Paris Descartes (EA2511), Sorbonne Paris Cité, Paris, France
Dept of Respiratory Medicine, Cochin Hospital, AP-HP, Paris, France
Paillasseur JL:
Effi-Stat, Paris, France
Janssens W:
Respiratory Division, University Hospital Gasthuisberg, K.U. Leuven, Leuven, Belgium
Piquet J:
Dept of Respiratory Medicine, Le Raincy-Montfermeil Hospital, Montfermeil, France
Ter Riet G:
Dept General Practice - Academic Medical Center, Amsterdam, The Netherlands
Garcia-Aymerich J:
ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra (UPF), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
Cosio B:
Unidad de Investigación, Servicio de Neumología, Hospital Universitario Son Espases, Palma de Mallorca, Spain
Bakke P:
Dept of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
Puhan MA:
Epidemiology, Biostatistics und Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
Langhammer A:
Dept of Public Health and General Practice, HUNT Research Centre, Norwegian University of Science and Technology, Levanger, Norway
Alfageme I:
Universidad de Sevilla, Seville, Spain
Almagro P:
Internal Medicine, Hospital Universitari Mutua de Terrassa, Universitat de Barcelona, Barcelona, Spain
Ancochea J:
Pneumology Service, La Princesa Institute for Health Research (IP), Hospital Universitario de la Princesa, Madrid, Spain
Celli BR:
Brigham and Women's Hospital, Boston, MA, USA
Casanova C:
Hospital Nuestra Señora de la Candelaria, Tenerife, Spain
de-Torres JP:
Clinica Universidad de Navarra, Pamplona, Spain
Decramer M:
Respiratory Division, University Hospital Gasthuisberg, K.U. Leuven, Leuven, Belgium
Echazarreta A:
Servicio de Neumonología Hospital San Juan de Dios de La Plata, Buenos Aires, Argentina
Esteban C:
Hospital Galdakao-Usansolo, Galdakao, Spain
Gomez Punter RM:
Servicio de Neumología, Hospital Universitario La Princesa, Madrid, Spain
Han MK:
University of Michigan, Ann Arbor, MI, USA
Johannessen A:
Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
Kaiser B:
Dept of Pulmonary Medicine, Paracelsus Medical University Hospital, Salzburg, Austria
Lamprecht B:
Dept of Pulmonary Medicine, General Hospital Linz (AKH), Linz, Austria
Lange P:
Section of Social Medicine, Dept of Public Health, Copenhagen University, Copenhagen, Denmark
Leivseth L:
Centre for Clinical Documentation and Evaluation, Northern Norway Regional Health Authority, Tromso, Norway
Marin JM:
Hospital Universitario Miguel Servet, Zaragoza, Spain
Martin F:
Pneumologie, Centre Hospitalier de Compiègne, Compiègne, France
Martinez-Camblor P:
Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
Universidad Autónoma de Chile, San Miguel, Chile
Miravitlles M:
Pneumology Dept, Hospital Universitary Vall d'Hebron. CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
Oga T:
Dept of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Sofia Ramírez A:
Facultad de Medicina UASLP, San Luis Potosí, México
Sin DD:
James Hogg Research Centre, University of British Columbia
Division of Respiratory Medicine, Dept of Medicine, St Paul's Hospital, Vancouver, Canada
Sobradillo P:
Hospital Universitario Araba, Sede Txagorritxu, Vitoria, Spain
:
Servicio de Neumología, Hospital Arnau de Vilanova, Valencia, Spain
Turner AM:
Queen Elizabeth Hospital Research Laboratories, Birmingham, UK
Verdu Rivera FJ:
H.U. Son Espases, Palma de Mallorca, Spain
Soriano JB:
Instituto de Investigación Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, Spain
Roche N:
Dept of Respiratory Medicine, Cochin Hospital, AP-HP, Paris, France
Univ Bergen, Fac Med & Dent, Dept Clin Sci, Bergen, Norway.
Green Accepted, Bronze, Green Submitted
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