دورية أكاديمية
أعرض في EDS

Prognostication of co-morbidity clusters on hospitalisation and mortality in advanced COPD.

التفاصيل البيبلوغرافية
العنوان: Prognostication of co-morbidity clusters on hospitalisation and mortality in advanced COPD.
المؤلفون: James BD; Department of Respiratory Sciences, University of Leicester, Leicester, UK., Greening NJ; Department of Respiratory Sciences, University of Leicester, Leicester, UK; Department of Respiratory Medicine, University Hospitals of Leicester, Leicester, UK., Tracey N; Department of Respiratory Medicine, University Hospitals of Leicester, Leicester, UK., Haldar P; Department of Respiratory Sciences, University of Leicester, Leicester, UK; Department of Respiratory Medicine, University Hospitals of Leicester, Leicester, UK., Woltmann G; Department of Respiratory Medicine, University Hospitals of Leicester, Leicester, UK., Free RC; Department of Respiratory Sciences, University of Leicester, Leicester, UK; School of Computing and Mathematical Sciences, University of Leicester, Leicester, UK., Steiner MC; Department of Respiratory Sciences, University of Leicester, Leicester, UK; Department of Respiratory Medicine, University Hospitals of Leicester, Leicester, UK., Evans RA; Department of Respiratory Sciences, University of Leicester, Leicester, UK; Department of Respiratory Medicine, University Hospitals of Leicester, Leicester, UK., Ward TJ; Department of Respiratory Sciences, University of Leicester, Leicester, UK; Department of Respiratory Medicine, University Hospitals of Leicester, Leicester, UK. Electronic address: tom.ward@leicester.ac.uk.
المصدر: Respiratory medicine [Respir Med] 2024 Feb; Vol. 222, pp. 107525. Date of Electronic Publication: 2024 Jan 03.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: England NLM ID: 8908438 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-3064 (Electronic) Linking ISSN: 09546111 NLM ISO Abbreviation: Respir Med Subsets: MEDLINE
أسماء مطبوعة: Publication: 2003- : Oxford : Elsevier
Original Publication: London : Baillière Tindall, in association with the British Thoracic Society, [c1989-
مواضيع طبية MeSH: Pulmonary Disease, Chronic Obstructive*, Humans ; Male ; Middle Aged ; Aged ; Female ; Comorbidity ; Hospitalization ; Depression ; Morbidity
مستخلص: Rationale: As the prevalence of multimorbidity increases, understanding the impact of isolated comorbidities in people COPD becomes increasingly challenging. A simplified model of common comorbidity patterns may improve outcome prediction and allow targeted therapy.
Objectives: To assess whether comorbidity phenotypes derived from routinely collected clinical data in people with COPD show differences in risk of hospitalisation and mortality.
Methods: Twelve clinical measures related to common comorbidities were collected during annual reviews for people with advanced COPD and k-means cluster analysis performed. Cox proportional hazards with adjustment for covariates was used to determine hospitalisation and mortality risk between clusters.
Measurements and Main Results: In 203 participants (age 66 ± 9 years, 60 % male, FEV 1 %predicted 31 ± 10 %) no comorbidity in isolation was predictive of worse admission or mortality risk. Four clusters were described: cluster A (cardiometabolic and anaemia), cluster B (malnourished and low mood), cluster C (obese, metabolic and mood disturbance) and cluster D (less comorbid). FEV 1 %predicted did not significantly differ between clusters. Mortality risk was higher in cluster A (HR 3.73 [95%CI 1.09-12.82] p = 0.036) and B (HR 3.91 [95%CI 1.17-13.14] p = 0.027) compared to cluster D. Time to admission was highest in cluster A (HR 2.01 [95%CI 1.11-3.63] p = 0.020). Cluster C was not associated with increased risk of mortality or hospitalisation.
Conclusions: Despite presence of advanced COPD, we report striking differences in prognosis for both mortality and hospital admissions for different co-morbidity phenotypes. Objectively assessing the multi-system nature of COPD could lead to improved prognostication and targeted therapy for patients.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
تواريخ الأحداث: Date Created: 20240105 Date Completed: 20240206 Latest Revision: 20240206
رمز التحديث: 20240206
DOI: 10.1016/j.rmed.2023.107525
PMID: 38182000
قاعدة البيانات: MEDLINE
الوصف
تدمد:1532-3064
DOI:10.1016/j.rmed.2023.107525