Abstract
Background: COPD is a heterogeneous condition with several clinical variants. The Czech Pneumological and Phthisiological Society defines 6 clinically relevant phenotypes: frequent exacerbator (FE), COPD-asthma overlap syndrome (ACOS), COPD-bronchiectasis overlap syndrome (BCOS), emphysematic phenotype (E), bronchitic phenotype (B), and pulmonary cachexia phenotype (CA).
Methods: The Czech Multicentre Research Database of COPD (NCT01923051) is a multicentre, observational, and prospective study of consecutive patients with severe COPD (post-BT FEV1≤60%). The primary objective is to assess the all-cause mortality, as well as the assessment of prognostic COPD indexes, identication of clinical phenotypes, lung function and respiratory symptoms.
Results: 647 severe COPD subjects were enrolled until Jan 2016. 637 of them were eligible for two-year analysis (67 ± 13yrs, post-BD FEV1 43.0±17.7%). On the whole, 388 (60.9%) were B, 254 (39.9%) were E, 193 (69.7%) were FE, 107 (16.8%) were BCOS, 94 (14.6%) were CA and 18 (2.8%) were ACOS subjects. 59 patients (16.1%) have died. We have found a significantly higher amount of deaths in the CA group (23, i.e. 30.7%, p < 0.001) and the FE group (24, i.e. 15.1%, p = 0.035). On the contrary there was no death in the ACOS group (0%). We confirmed a good correlation between mortality and the ADO index (p < 0.003) and the Yokohama score (YCS) (p = 0.025).
Conclusion: Two clinical phenotypes, CA and FE, are associated with a significantly higher risk of death. ADO index and YCS appear to be suitable prognostic tools.
- Copyright ©the authors 2016
