A simple algorithm for the identification of clinical COPD phenotypes

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Pierre-Régis Burgel, Jean-Louis Paillasseur, Wim Janssens, Jacques Piquet, Gerben ter Riet, Judith Garcia-Aymerich, Borja Cosio, Per Bakke, Milo A. Puhan, Arnulf Langhammer, Inmaculada Alfageme, Pere Almagro, Julio Ancochea, Bartolome R. Celli, Ciro Casanova, Juan P. de-Torres, Marc Decramer, Andrés Echazarreta, Cristobal Esteban, Rosa Mar Gomez Punter & 19 more MeiLan K. Han, Ane Johannessen, Bernhard Kaiser, Bernd Lamprecht, Peter Lange, Linda Leivseth, Jose M. Marin, Francis Martin, Pablo Martinez-Camblor, Marc Miravitlles, Toru Oga, Ana Sofia Ramírez, Don D. Sin, Patricia Sobradillo, Juan J. Soler-Cataluna, Alice M. Turner, Francisco Javier Verdu Rivera, Joan B. Soriano, Nicolas Roche

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.
Original languageEnglish
Article number1701034
JournalEuropean Respiratory Journal
Volume50
Issue number5
Pages (from-to)1-11
Number of pages11
ISSN0903-1936
DOIs
Publication statusPublished - Nov 2017

ID: 188196312