TY - JOUR T1 - Interaction of relevant domains in the heterogeneity of severe COPD exacerbations: The exacerbome network JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P3229 AU - Borja G. Cosio AU - Dolores Guerrero AU - Rocio Cordova AU - German Peces-Barba AU - Cristobal Esteban AU - Alfredo de Diego AU - Joaquim Gea AU - Marian Garcia-Nuñez AU - Eduard Monsó AU - Alvar Agusti Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P3229.abstract N2 - Different factors may play a role in the pathogenesis of COPD exacerbations (ECOPD). The Exacerbations of COPD in Spain (ECOS) is a multi-center longitudinal study aimed to improve our understanding of the pathobiology and heterogeneity of ECOPD. We aimed to explore the weight and interaction of the different domains that are involved in the heterogeneity of the disease by building a network that link and relate all of them (exacerbome). In the ECOS study we included 99 patients in whom we obtained a battery of tests during hospitalization because of ECOPD, when clinically stable and after discharge. A selection of variables from the demographic, symptoms, lung function, biology, microbiology and imaging domains were analyzed and used to construct the exacerbome, where each node correspond to each of these variables, node size was proportional to the percentage of abnormal values of that particular variable and nodes were linked if there was a statistically significant correlation between the two variables being explored. Dyspnea, presence of bacteria in sputum by polimerase chain reaction, leukocytosis, active smoking, pulmonary hypertension on echocardiography, PaCO2, inspiratory capacity to total lung capacity (IC/TLC) and fibrinogen were the most important and interconected nodes of the exacerbome on admission whereas age, dyspnea, presence of bacteria in sputum, presence of emphysema, diffusing capacity and blood eosinophils higher than 2% were the most important nodes on stability. These results show that network analysis is a novel approach to help understanding the heterogeneity of severe ECOPD.Supported by FIS 05/1463 and an unrestricted research grant from GSK. ER -