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...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2022-12-01
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| Series: | COPD |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/15412555.2022.2039608 |
| _version_ | 1797403999419236352 |
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| author | 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 |
| author_facet | 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 |
| author_sort | S. Gagatek |
| collection | DOAJ |
| description | 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 . |
| first_indexed | 2024-03-09T02:47:47Z |
| format | Article |
| id | doaj.art-d14191ee776441a89e5747303201f88e |
| institution | Directory Open Access Journal |
| issn | 1541-2555 1541-2563 |
| language | English |
| last_indexed | 2024-03-09T02:47:47Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | COPD |
| spelling | doaj.art-d14191ee776441a89e5747303201f88e2023-12-05T16:09:50ZengTaylor & Francis GroupCOPD1541-25551541-25632022-12-0119133033810.1080/15412555.2022.20396082039608Validation of Clinical COPD Phenotypes for Prognosis of Long-Term Mortality in Swedish and Dutch CohortsS. Gagatek0S. R. A. Wijnant1B. Ställberg2K. Lisspers3G. Brusselle4X. Zhou5M. Hasselgren6S. Montgomeryi7J. Sundhj8C. Janson9Ö. Emilsson10L. Lahousse11A. Malinovschi12Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala UniversityDepartment of Respiratory Medicine, Ghent University HospitalDepartment of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala UniversityDepartment of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala UniversityDepartment of Respiratory Medicine, Ghent University HospitalDepartment of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala UniversitySchool of Medical Sciences, Faculty of Medicine and Health, Örebro UniversityClinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro UniversityDepartment of Respiratory Medicine, Faculty of Medicine and Health, Örebro UniversityDepartment of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala UniversityDepartment of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala UniversityDepartment of Epidemiology, Erasmus Medical CentreDepartment of Medical Sciences: Clinical Physiology, Uppsala UniversityChronic 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 .http://dx.doi.org/10.1080/15412555.2022.2039608copdphenotypesmortalitycomorbiditiesepidemiology |
| spellingShingle | 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 Validation of Clinical COPD Phenotypes for Prognosis of Long-Term Mortality in Swedish and Dutch Cohorts COPD copd phenotypes mortality comorbidities epidemiology |
| title | Validation of Clinical COPD Phenotypes for Prognosis of Long-Term Mortality in Swedish and Dutch Cohorts |
| title_full | Validation of Clinical COPD Phenotypes for Prognosis of Long-Term Mortality in Swedish and Dutch Cohorts |
| title_fullStr | Validation of Clinical COPD Phenotypes for Prognosis of Long-Term Mortality in Swedish and Dutch Cohorts |
| title_full_unstemmed | Validation of Clinical COPD Phenotypes for Prognosis of Long-Term Mortality in Swedish and Dutch Cohorts |
| title_short | Validation of Clinical COPD Phenotypes for Prognosis of Long-Term Mortality in Swedish and Dutch Cohorts |
| title_sort | validation of clinical copd phenotypes for prognosis of long term mortality in swedish and dutch cohorts |
| topic | copd phenotypes mortality comorbidities epidemiology |
| url | http://dx.doi.org/10.1080/15412555.2022.2039608 |
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