Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2018 Jul 16;18(1):117.
doi: 10.1186/s12890-018-0684-7.

Comorbidities and COPD severity in a clinic-based cohort

Chantal Raherison  1   2   3 , El-Hassane Ouaalaya  4 , Alain Bernady  5 , Julien Casteigt  6 , Cecilia Nocent-Eijnani  7 , Laurent Falque  8 , Frédéric Le Guillou  9 , Laurent Nguyen  10 , Annaig Ozier  10 , Mathieu Molimard  11
Affiliations
Observational Study

Comorbidities and COPD severity in a clinic-based cohort

Chantal Raherison et al. BMC Pulm Med. .

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality around the world. The aim of our study was to determine the association between specific comorbidities and COPD severity.

Methods: Pulmonologists included patients with COPD using a web-site questionnaire. Diagnosis of COPD was made using spirometry post-bronchodilator FEV1/FVC < 70%. The questionnaire included the following domains: demographic criteria, clinical symptoms, functional tests, comorbidities and therapeutic management. COPD severity was classified according to GOLD 2011. First we performed a principal component analysis and a non-hierarchical cluster analysis to describe the cluster of comorbidities.

Results: One thousand, five hundred and eighty-four patients were included in the cohort during the first 2 years. The distribution of COPD severity was: 27.4% in group A, 24.7% in group B, 11.2% in group C, and 36.6% in group D. The mean age was 66.5 (sd: 11), with 35% of women. Management of COPD differed according to the comorbidities, with the same level of severity. Only 28.4% of patients had no comorbidities associated with COPD. The proportion of patients with two comorbidities was significantly higher (p < 0.001) in GOLD B (50.4%) and D patients (53.1%) than in GOLD A (35.4%) and GOLD C ones (34.3%). The cluster analysis showed five phenotypes of comorbidities: cluster 1 included cardiac profile; cluster 2 included less comorbidities; cluster 3 included metabolic syndrome, apnea and anxiety-depression; cluster 4 included denutrition and osteoporosis and cluster 5 included bronchiectasis. The clusters were mostly significantly associated with symptomatic patients i.e. GOLD B and GOLD D.

Conclusions: This study in a large real-life cohort shows that multimorbidity is common in patients with COPD.

Keywords: COPD; Cluster analysis; Comorbidities; Management.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The CNIL (National Data Protection and Privacy Commission) and the CCTIRS (Advisory Committee for Data Processing in Health Research) approved the study, and informed verbal consent was obtained before enrollment. The authors had asked the local ethics committee for feedback regarding the need for ethical clearance for such a retrospective analysis, and were advised that this was not warranted.

Consent for publication

Not applicable.

Competing interests

Dr. Raherison reports grants from Bordeaux University Foundation, during the conduct of the study; personal fees from Astra Zeneca, personal fees from Chiesi, personal fees from ALK, personal fees from Boehringer Ingelheim, personal fees from Glaxo SmithKline, personal fees from MundiPharma, personal fees from Novartis, outside the submitted work; Dr. Nocent-Eijnani has nothing to disclose.

Dr. Molimard reports personal fee from the University of Bordeaux, during the conduct of the study, other from Novartis Pharma, GSK, MundiPharma outside the submitted work. Dr. Nguyen has nothing to disclose. Dr. Falque has nothing to disclose. Dr. Casteigt has nothing to disclose. Dr. Le Guillou has nothing to disclose. Dr. Ozier has nothing to disclose. Dr. Bernady has nothing to disclose. Mr. Ouaalaya has nothing to disclose.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Frequency of COPD severity by number of comorbidities
See this image and copyright information in PMC

References

    1. Thun MJ, et al. 50-year trends in smoking-related mortality in the United States. N Engl J Med. 2013;368(4):351–364. doi: 10.1056/NEJMsa1211127. - DOI - PMC - PubMed
    1. National Heart, L., and Blood Institute. World Health Organization., Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. NHLBI/WHO Workshop Report 2011. Vestbo J: National Institutes of Health; 2014. Available from: https://goldcopd.org/gold-reports-2017/.
    1. Divo M, et al. Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2012;186(2):155–161. doi: 10.1164/rccm.201201-0034OC. - DOI - PubMed
    1. Celli BR, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med. 2004;350(10):1005–1012. doi: 10.1056/NEJMoa021322. - DOI - PubMed
    1. Lange P, et al. Prediction of the clinical course of chronic obstructive pulmonary disease, using the new GOLD classification: a study of the general population. Am J Respir Crit Care Med. 2012;186(10):975–981. doi: 10.1164/rccm.201207-1299OC. - DOI - PubMed

Publication types