期刊
THORAX
卷 66, 期 5, 页码 430-437出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/thx.2010.154484
关键词
-
资金
- Fondo de Investigacion Sanitaria, Ministry of Health, Spain [FIS PI020541]
- Agencia d'Avaluacio de Tecnologia i Recerca Mediques, Catalonia government [AATRM 035/20/02]
- Spanish Society of Pneumology and Thoracic Surgery [SEPAR 2002/137]
- Catalan Foundation of Pneumology [FUCAP 2003]
- Red RESPIRA [RTIC C03/11]
- Red RCESP [RTIC C03/09]
- Fondo de Investigacion Sanitaria [PI052486, PI052302]
- Fundacio La Marato de TV3 [041110]
- Novartis Farmaceutica, Spain
- Instituto de Salud Carlos III, Ministry of Health, Spain
- Instituto de Salud Carlos III, Ministry of Health, Spain [CP05/00118]
- Generalitat de Catalunya
Background Chronic obstructive pulmonary disease (COPD) is increasingly considered a heterogeneous condition. It was hypothesised that COPD, as currently defined, includes different clinically relevant subtypes. Methods To identify and validate COPD subtypes, 342 subjects hospitalised for the first time because of a COPD exacerbation were recruited. Three months after discharge, when clinically stable, symptoms and quality of life, lung function, exercise capacity, nutritional status, biomarkers of systemic and bronchial inflammation, sputum microbiology, CT of the thorax and echocardiography were assessed. COPD groups were identified by partitioning cluster analysis and validated prospectively against cause-specific hospitalisations and all-cause mortality during a 4 year follow-up. Results Three COPD groups were identified: group 1 (n=126, 67 years) was characterised by severe airflow limitation (postbronchodilator forced expiratory volume in 1 s (FEV1) 38% predicted) and worse performance in most of the respiratory domains of the disease; group 2 (n=125, 69 years) showed milder airflow limitation (FEV1 63% predicted); and group 3 (n=91, 67 years) combined a similarly milder airflow limitation (FEV1 58% predicted) with a high proportion of obesity, cardiovascular disorders, diabetes and systemic inflammation. During follow-up, group 1 had more frequent hospitalisations due to COPD (HR 3.28, p < 0.001) and higher all-cause mortality (HR 2.36, p=0.018) than the other two groups, whereas group 3 had more admissions due to cardiovascular disease (HR 2.87, p=0.014). Conclusions In patients with COPD recruited at their first hospitalisation, three different COPD subtypes were identified and prospectively validated: 'severe respiratory COPD', 'moderate respiratory COPD', and 'systemic COPD'.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据