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Int J Chron Obstruct Pulmon Dis. 2018 Jul 20;13:2245-2251. doi: 10.2147/COPD.S166163. eCollection 2018.

COPD phenotypes: differences in survival.

Author information

1
Respiratory Department, Hospital Universitario Infanta Leonor, Madrid, Spain.
2
Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain, rodrigo.jimenez@urjc.es.
3
Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.

Abstract

Background:

The aim of the study was to analyze the characteristics and survival of a group of patients with COPD according to their clinical phenotype.

Patients and methods:

The study population was selected from patients undergoing scheduled spirometry between January 1, 2011 and June 30, 2011 at the respiratory function laboratory of a teaching hospital and comprised those with a previous and confirmed diagnosis of COPD and forced expiratory volume in the first second (FEV1) of <70%. The patients selected were classified into 4 groups: positive bronchodilator response, non-exacerbator, exacerbator with emphysema, and exacerbator with chronic bronchitis. Patients were followed up until April 2017.

Results:

We recruited 273 patients, of whom 89% were men. The distribution by phenotype was as follows: non-exacerbator, 47.2%; positive bronchodilator response, 25.8%; exacerbator with chronic bronchitis, 13.8%; and exacerbator with emphysema, 13.0%. A total of 90 patients died during follow-up (32.9%). Taking patients with a positive bronchodilator response as the reference category, the risk factors that were independently associated with death were older age (HR, 1.06; 95% CI, 1.03-1.09), lower FEV1 (HR, 0.98; 95% CI, 0.96-0.99), and exacerbator with chronic bronchitis phenotype (HR, 3.28; 95% CI, 1.53-7.03).

Conclusion:

Classification of COPD patients by phenotype makes it possible to identify subgroups with different prognoses. Thus, mortality was greater in exacerbators with chronic bronchitis and lower in those with a positive bronchodilator response.

KEYWORDS:

COPD; chronic bronchitis; emphysema; exacerbator; mortality; phenotypes; positive bronchodilator response

PMID:
30050297
PMCID:
PMC6055897
DOI:
10.2147/COPD.S166163
[Indexed for MEDLINE]
Free PMC Article

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