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RETRO-POPE: A Retrospective, Multicenter, Real-World Study of All-Cause Mortality in COPD.
Koblizek, Vladimir; Milenkovic, Branislava; Svoboda, Michal; Kocianova, Jana; Holub, Stanislav; Zindr, Vladimir; Ilic, Miroslav; Jankovic, Jelena; Cupurdija, Vojislav; Jarkovsky, Jiri; Popov, Boris; Valipour, Arschang.
Afiliação
  • Koblizek V; Department of Pneumology, University Hospital, Hradec Kralove, Czech Republic.
  • Milenkovic B; Faculty of Medicine Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.
  • Svoboda M; Clinic for Pulmonary Diseases, Clinical Center of Serbia, Belgrade, Serbia.
  • Kocianova J; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
  • Holub S; Institute of Biostatistics and Analyses Ltd., Brno, Czech Republic.
  • Zindr V; Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
  • Ilic M; Outpatient Department of Pneumology Alveolus, APRO MED, Ostrava, Czech Republic.
  • Jankovic J; Outpatient Chest Clinic, Plicni Stredisko Teplice Ltd., Teplice, Czech Republic.
  • Cupurdija V; Outpatient Chest Clinic, PNEUMO KV Ltd., Karlovy Vary, Czech Republic.
  • Jarkovsky J; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
  • Popov B; Clinic for Tuberculosis and Interstitial Lung Diseases, PolyClinic Department, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia.
  • Valipour A; Clinic for Pulmonary Diseases, Clinical Center of Serbia, Belgrade, Serbia.
Int J Chron Obstruct Pulmon Dis ; 18: 2661-2672, 2023.
Article em En | MEDLINE | ID: mdl-38022829
ABSTRACT

Purpose:

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. Patients and

Methods:

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.

Results:

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%).

Conclusion:

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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Bronquite Crônica / Doença Pulmonar Obstrutiva Crônica Limite: Humans Idioma: En Revista: Int J Chron Obstruct Pulmon Dis Ano de publicação: 2023 Tipo de documento: Article País de afiliação: República Tcheca

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Bronquite Crônica / Doença Pulmonar Obstrutiva Crônica Limite: Humans Idioma: En Revista: Int J Chron Obstruct Pulmon Dis Ano de publicação: 2023 Tipo de documento: Article País de afiliação: República Tcheca