中欧和东欧的COPD表型(POPE)研究评估了四种临床COPD表型的患病率和临床特征,但不是死亡率。这项对POPE研究(RETRO-POPE)的回顾性分析使用两种分组方法调查了全因死亡率与患者特征之间的关系:临床表型(如POPE)和Burgel聚类,以更好地识别高危患者。
■两个最大的POPE研究患者队列(捷克共和国和塞尔维亚)被归类为四种临床表型之一(急性exacerbators[伴/不伴慢性支气管炎],非精确的,哮喘-COPD重叠),和基于合并症的五个Burgel集群之一,肺功能,年龄,体重指数(BMI)和呼吸困难(非常严重的合并症,非常严重的呼吸,中度至重度呼吸,中度至重度共病/肥胖,和轻微的呼吸)。对患者的生存状态进行了大约7年的随访。
■总的来说,1,003名接受筛查的患者中有801名具有足够的分析数据。其中,440例患者(54.9%)存活,361例(45.1%)在随访结束时死亡。根据临床表型对生存率的分析显示,表型之间没有显着差异(P=0.211)。然而,Burgel聚类显示集群之间的生存率存在显着差异(P<0.001),患有“非常严重的共病”和“非常严重的呼吸系统”的患者最有可能死亡。调整年龄后,塞尔维亚和捷克共和国的总体生存率没有显着差异,BMI,合并症和1秒用力呼气量(风险比[HR]0.80,95%置信区间[CI]0.65-0.99;P=0.036[未调整];HR0.88,95%CI0.7-1.1;P=0.257[调整])。最常见的死亡原因是与呼吸有关的(36.8%),其次是心血管(25.2%),然后是肿瘤(15.2%)。
■基于合并症的患者群集,肺功能,年龄,BMI和呼吸困难更可能显示COPD死亡风险的差异,而不是由加重史和是否存在慢性支气管炎和/或哮喘特征定义的表型。
UNASSIGNED: The Phenotypes of COPD in Central and Eastern Europe (POPE)
study assessed the prevalence and clinical characteristics of four clinical COPD phenotypes, but not mortality. This retrospective analysis of the POPE
study (RETRO-POPE) investigated the relationship between all-cause mortality and patient characteristics using two grouping methods: clinical phenotyping (as in POPE) and Burgel clustering, to better identify high-risk patients.
UNASSIGNED: The two largest POPE
study patient cohorts (Czech Republic and Serbia) were categorized into one of four clinical phenotypes (acute exacerbators [with/without chronic bronchitis], non-exacerbators, asthma-COPD overlap), and one of five Burgel clusters based on comorbidities, lung function, age, body mass index (BMI) and dyspnea (very severe comorbid, very severe respiratory, moderate-to-severe respiratory, moderate-to-severe comorbid/obese, and mild respiratory). Patients were followed-up for approximately 7 years for survival status.
UNASSIGNED: Overall, 801 of 1,003 screened patients had sufficient data for analysis. Of these, 440 patients (54.9%) were alive and 361 (45.1%) had died at the end of follow-up. Analysis of survival by clinical phenotype showed no significant differences between the phenotypes (P=0.211). However, Burgel clustering demonstrated significant differences in survival between clusters (P<0.001), with patients in the \"very severe comorbid\" and \"very severe respiratory\" clusters most likely to die. Overall survival was not significantly different between Serbia and the Czech Republic after adjustment for age, BMI, comorbidities and forced expiratory volume in 1 second (hazard ratio [HR] 0.80, 95% confidence interval [CI] 0.65-0.99; P=0.036 [unadjusted]; HR 0.88, 95% CI 0.7-1.1; P=0.257 [adjusted]). The most common causes of death were respiratory-related (36.8%), followed by cardiovascular (25.2%) then neoplasm (15.2%).
UNASSIGNED: Patient clusters based on comorbidities, lung function, age, BMI and dyspnea were more likely to show differences in COPD mortality risk than phenotypes defined by exacerbation history and presence/absence of chronic bronchitis and/or asthmatic features.