Abstract
Introduction: The aim of the study was to assess the impact of decreased 6MWT and exercise-induced desaturation (EID) on long-term survival and mortality related to Czech and Spanish phenotypes in patients with severe COPD.
Methods: CMRD is a prospective, observational and multicentre study focussing on the collection and analysis of data on real mortality and morbidity in an unselected population of COPD.
Results: A total of 598 patients with performed 6MWT were analysed. Overall 5-year mortality was 33.8% (202 patients). Using the ROC analyses, the statistically significant cut-off value for the 6MWD was 312.5 m (AUC 0.667; p<0.001). At the cut-off value <315 m, the estimate of 5-year survival was 36.7% and HR 2.461 compared to the group of ≥315 m 69.2% (p<0.001). Using the Czech phenotypic approach with the cut-off value <315 m, the lowest estimated 5-year survival was found in the cachexy group – 21.2% (p=0.001). Statistically significant decrease in 5-year survival - 51.4% (p=0.022; HR 1.389) was observed in the group with EID compared to the group with no desaturation (59.3%). Using the Czech phenotypic approach, we have found the lowest 5-year survival related to EID in the cachexy - 31.0% (p=0.001) and the frequent exacerbator phenotype - 42.0% (p=0.015). In contrast, we haven’t found any statistical significance using the Spanish phenotypes.
Conclusion: In our cohort, the cachexy phenotype was significantly associated with lower long-term survival in the groups with decreased 6MWT and EID. We believe that identifying the clinical relevant phenotypes within COPD can guide us to a more personalised treatment.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA4327.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019