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Validation of clinical clusters for long-term mortality in two European COPD cohorts

Sebastian Grzegorz Gagatek, Sara Wijnant, Björn Ställberg, Karin Lisspers, Guy Brusselle, Xing Wu Zhou, Mikael Hasselgren, Scott Montgomery, Josefin Sundh, Janson Christer, Össur Emilsson, Lies Lahousse, Andrei Malinovschi
European Respiratory Journal 2020 56: 4914; DOI: 10.1183/13993003.congress-2020.4914
Sebastian Grzegorz Gagatek
1Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
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  • For correspondence: sebastian.gagatek@akademiska.se
Sara Wijnant
2Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
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Björn Ställberg
3Department of Public Health and Caring Sciences, Family Medicine and Preventive medicine, Uppsala University, Uppsala, Sweden
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Karin Lisspers
3Department of Public Health and Caring Sciences, Family Medicine and Preventive medicine, Uppsala University, Uppsala, Sweden
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Guy Brusselle
2Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
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Xing Wu Zhou
1Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
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Mikael Hasselgren
4School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Scott Montgomery
5Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
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Josefin Sundh
6Department of Respiratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Janson Christer
1Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
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Össur Emilsson
1Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
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Lies Lahousse
7Department of Epidemiology, Erasmus Medical Centre, Rotterdam, Netherlands
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Andrei Malinovschi
8Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
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Abstract

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous disease with a variable mortality risk. A simple clinical algorithm has been validated for short-term mortality by Burgel et al. (ERJ 2017).

Aim: To study if Burgel’s clinical algorithm is valid to predict long-term mortality.

Methods: Data from two COPD cohorts, the Swedish PRAXIS Study (PS) (n=784, mean age (SD) 64.0 years (7.5), 42% males) and the Rotterdam Study (RS) (n=735, mean age (SD) 72 years (9.2), 57% males), with 9-years of follow-up data including mortality was used. The five clinical clusters were derived from baseline data on age, body mass index, dyspnea grade (mMRC), FEV 1 (%pred) and comorbidity (cardiovascular disease or diabetes). Mortality risk was estimated by unadjusted Cox models.

Results: The distribution of clinical clusters (1-5) was: 29%/45%/8%/6%/12% in PS and 23%/26%/36%/0/15% in RS. The cumulative proportion of deaths after 9-years of follow-up was highest among COPD clusters 1 (65%) and 4 (72%), and lowest among cluster 5 (10%) in the PS cohort. In RS, Cluster 1 (44%) had the highest cumulative mortality and cluster 5 (5%) the lowest. Compared to cluster 5, the meta-analysed hazard ratio (HR) (95%CI) for cluster 1 was 9.95 (6.52–15.19) and for cluster 4, 13.49 (6.41–28.38). The meta-analysed HR for clusters 2 and 3, compared with cluster 5, were: 2.80 (1.77 – 4.36) and 4.73 (3.02 – 7.42), respectively.

Conclusions: Burgel’s clinical clusters can be used to predict long-term mortality risk. Clusters 1 and 4 are associated with the poorest prognosis, cluster 5 with best prognosis and clusters 2 and 3 with intermediate prognosis in two independent COPD cohorts from Sweden and Netherlands.

  • COPD
  • Comorbidities

Footnotes

Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 4914.

This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.

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 2020
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Validation of clinical clusters for long-term mortality in two European COPD cohorts
Sebastian Grzegorz Gagatek, Sara Wijnant, Björn Ställberg, Karin Lisspers, Guy Brusselle, Xing Wu Zhou, Mikael Hasselgren, Scott Montgomery, Josefin Sundh, Janson Christer, Össur Emilsson, Lies Lahousse, Andrei Malinovschi
European Respiratory Journal Sep 2020, 56 (suppl 64) 4914; DOI: 10.1183/13993003.congress-2020.4914

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Validation of clinical clusters for long-term mortality in two European COPD cohorts
Sebastian Grzegorz Gagatek, Sara Wijnant, Björn Ställberg, Karin Lisspers, Guy Brusselle, Xing Wu Zhou, Mikael Hasselgren, Scott Montgomery, Josefin Sundh, Janson Christer, Össur Emilsson, Lies Lahousse, Andrei Malinovschi
European Respiratory Journal Sep 2020, 56 (suppl 64) 4914; DOI: 10.1183/13993003.congress-2020.4914
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