Prediction of first acute exacerbation using COPD subtypes identified by cluster analysis

International Journal of Chronic Obstructive Pulmonary Disease
Hee-Young YoonJin Hwa Lee

Abstract

In patients with COPD, acute exacerbation (AE) is not only an important determinant of prognosis, but also an important factor in choosing therapeutic agents. In this study, we evaluated the usefulness of COPD subtypes identified through cluster analysis to predict the first AE. Among COPD patients in the Korea COPD Subgroup Study (KOCOSS) cohort, 1,195 who had follow-up data for AE were included in our study. We selected seven variables for cluster analysis - age, body mass index, smoking status, history of asthma, COPD assessment test (CAT) score, post-bronchodilator (BD) FEV1 % predicted, and diffusing capacity of carbon monoxide % predicted. K-means clustering identified four clusters for COPD that we named putative asthma-COPD overlap (ACO), mild COPD, moderate COPD, and severe COPD subtypes. The ACO group (n=196) showed the second-best post-BD FEV1 (75.5% vs 80.9% [mild COPD, n=313] vs 52.4% [moderate COPD, n=345] vs 46.7% [severe COPD, n=341] predicted), the longest 6-min walking distance (424 m vs 405 m vs 389  m vs 365 m), and the lowest CAT score (12.2 vs 13.7 vs 15.6 vs 17.5) among the four groups. ACO group had greater risk for first AE compared to the mild COPD group (HR, 1.683; 95% CI, 1.175-2.410). The moderate C...Continue Reading

Citations

Jul 19, 2020·Journal of Clinical Medicine·Anna Karen Gárate-EscamillaAmir Hajjam El Hassani
Aug 31, 2020·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Kuniaki HiraiHironori Sagara
Mar 11, 2021·International Journal of Chronic Obstructive Pulmonary Disease·Kristijonas PuteikisElena Jurevičienė

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