TY - JOUR T1 - Clinical differences between emphysematous and non-emphysematous COPD JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2016.PA4183 VL - 48 IS - suppl 60 SP - PA4183 AU - Manu Madan AU - Pawan Gupta AU - Richa Mittal AU - Sunil Chhabra Y1 - 2016/09/01 UR - http://erj.ersjournals.com/content/48/suppl_60/PA4183.abstract N2 - Introduction: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification of Chronic Obstructive Pulmonary Disease (COPD) does not take cognizance of its heterogeneity. Identification of clinical phenotypes may help in tailoring personalized treatments. The present study was carried out to characterize the emphysema phenotype in terms of clinically-relevant parameters: lung function, patient-entered outcomes and risk predictions.Methods: Forty three stable patients, 45 to 80 years of age, current or ex-smokers, with a diagnosis of COPD were evaluated by a detailed history, spirometry, diffusion capacity measurements and six minute walk test. Health status was assessed by the St. George's Respiratory Questionnaire (SGRQ) and COPD Assessment test (CAT). BODE (Body-Mass Index, Obstruction, Dyspnea, Exercise) and ADO (Age, Dyspnea, Obstruction) scores were computed as predictors of adverse outcomes. High-resolution computed tomography was carried out to identify emphysema, defined as low attenuation areas of less than 950 Hounsfield units. The patients were divided into those with and without emphysema and compared.Results: Twenty five patients had emphysema. These were older, had longer duration of disease, greater intensity of smoking and greater grades of dyspnea. They had greater airways obstruction and lower diffusion capacity. They also had a poorer quality of life and greater BODE and ADO scores.Conclusions: Patients with emphysema have a poorer lung function, a greater impact on patient-centered outcomes and carry more adverse risk predictions than those without emphysema. As it has therapeutic implications, identification of the emphysema phenotype may be clinically meaningful. ER -