Format

Send to

Choose Destination
BMC Pulm Med. 2018 Jul 16;18(1):117. doi: 10.1186/s12890-018-0684-7.

Comorbidities and COPD severity in a clinic-based cohort.

Author information

1
Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team EPICENE, UMR 1219, F-33000, Bordeaux, France. Chantal.raherison@chu-bordeaux.fr.
2
Pole cardiothoracique, Respiratory Diseases Department, CHU de Bordeaux, F-33000, Bordeaux, France. Chantal.raherison@chu-bordeaux.fr.
3
Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team EPICENE, UMR 1219, 146 rue Leo Saignat, 33076 Cedex, Bordeaux, France. Chantal.raherison@chu-bordeaux.fr.
4
Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team EPICENE, UMR 1219, F-33000, Bordeaux, France.
5
Rehabiliation Center, Cambo-les-Bains, France.
6
Pneumology Clinic, St Medard en Jalles, France.
7
General Hospital, Bayonne, France.
8
Pneumology Clinic, Bordeaux, France.
9
Pneumology Clinic, La Rochelle, France.
10
Pneumology Clinic, St Augustin, Bordeaux, France.
11
U1219 Pharmaco-epidemiology, Bordeaux University, Bordeaux, France.

Abstract

BACKGROUND:

Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality around the world. The aim of our study was to determine the association between specific comorbidities and COPD severity.

METHODS:

Pulmonologists included patients with COPD using a web-site questionnaire. Diagnosis of COPD was made using spirometry post-bronchodilator FEV1/FVC < 70%. The questionnaire included the following domains: demographic criteria, clinical symptoms, functional tests, comorbidities and therapeutic management. COPD severity was classified according to GOLD 2011. First we performed a principal component analysis and a non-hierarchical cluster analysis to describe the cluster of comorbidities.

RESULTS:

One thousand, five hundred and eighty-four patients were included in the cohort during the first 2 years. The distribution of COPD severity was: 27.4% in group A, 24.7% in group B, 11.2% in group C, and 36.6% in group D. The mean age was 66.5 (sd: 11), with 35% of women. Management of COPD differed according to the comorbidities, with the same level of severity. Only 28.4% of patients had no comorbidities associated with COPD. The proportion of patients with two comorbidities was significantly higher (p < 0.001) in GOLD B (50.4%) and D patients (53.1%) than in GOLD A (35.4%) and GOLD C ones (34.3%). The cluster analysis showed five phenotypes of comorbidities: cluster 1 included cardiac profile; cluster 2 included less comorbidities; cluster 3 included metabolic syndrome, apnea and anxiety-depression; cluster 4 included denutrition and osteoporosis and cluster 5 included bronchiectasis. The clusters were mostly significantly associated with symptomatic patients i.e. GOLD B and GOLD D.

CONCLUSIONS:

This study in a large real-life cohort shows that multimorbidity is common in patients with COPD.

KEYWORDS:

COPD; Cluster analysis; Comorbidities; Management

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center