Comorbidities and COPD severity in a clinic-based cohort
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-s...
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doaj-f2e7cf7eb993466b967ab019d2f815692020-11-25T01:13:04ZengBMCBMC Pulmonary Medicine1471-24662018-07-0118111010.1186/s12890-018-0684-7Comorbidities and COPD severity in a clinic-based cohortChantal Raherison0El-Hassane Ouaalaya1Alain Bernady2Julien Casteigt3Cecilia Nocent-Eijnani4Laurent Falque5Frédéric Le Guillou6Laurent Nguyen7Annaig Ozier8Mathieu Molimard9Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team EPICENE, UMR 1219Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team EPICENE, UMR 1219Rehabiliation CenterPneumology ClinicGeneral HospitalPneumology ClinicPneumology ClinicPneumology Clinic, St AugustinPneumology Clinic, St AugustinU1219 Pharmaco-epidemiology, Bordeaux UniversityAbstract 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.http://link.springer.com/article/10.1186/s12890-018-0684-7COPDComorbiditiesCluster analysisManagement |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chantal Raherison El-Hassane Ouaalaya Alain Bernady Julien Casteigt Cecilia Nocent-Eijnani Laurent Falque Frédéric Le Guillou Laurent Nguyen Annaig Ozier Mathieu Molimard |
spellingShingle |
Chantal Raherison El-Hassane Ouaalaya Alain Bernady Julien Casteigt Cecilia Nocent-Eijnani Laurent Falque Frédéric Le Guillou Laurent Nguyen Annaig Ozier Mathieu Molimard Comorbidities and COPD severity in a clinic-based cohort BMC Pulmonary Medicine COPD Comorbidities Cluster analysis Management |
author_facet |
Chantal Raherison El-Hassane Ouaalaya Alain Bernady Julien Casteigt Cecilia Nocent-Eijnani Laurent Falque Frédéric Le Guillou Laurent Nguyen Annaig Ozier Mathieu Molimard |
author_sort |
Chantal Raherison |
title |
Comorbidities and COPD severity in a clinic-based cohort |
title_short |
Comorbidities and COPD severity in a clinic-based cohort |
title_full |
Comorbidities and COPD severity in a clinic-based cohort |
title_fullStr |
Comorbidities and COPD severity in a clinic-based cohort |
title_full_unstemmed |
Comorbidities and COPD severity in a clinic-based cohort |
title_sort |
comorbidities and copd severity in a clinic-based cohort |
publisher |
BMC |
series |
BMC Pulmonary Medicine |
issn |
1471-2466 |
publishDate |
2018-07-01 |
description |
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. |
topic |
COPD Comorbidities Cluster analysis Management |
url |
http://link.springer.com/article/10.1186/s12890-018-0684-7 |
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