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Observational Study
. 2022 May 24;12(1):8790.
doi: 10.1038/s41598-022-12828-8.

Sex-specific associations of comorbidome and pulmorbidome with mortality in chronic obstructive pulmonary disease: results from COSYCONET

Franziska C Trudzinski  1 , Rudolf A Jörres  2 , Peter Alter  3 , Julia Walter  4 , Henrik Watz  5 , Andrea Koch  6 , Matthias John  7 , Marek Lommatzsch  8 , Claus F Vogelmeier  3 , Hans-Ulrich Kauczor  9 , Tobias Welte  10 , Jürgen Behr  4 , Amanda Tufman  4 , Robert Bals  11 , Felix J F Herth  12 , Kathrin Kahnert  4 ; COSYCONET Study Group
Collaborators, Affiliations
Observational Study

Sex-specific associations of comorbidome and pulmorbidome with mortality in chronic obstructive pulmonary disease: results from COSYCONET

Franziska C Trudzinski et al. Sci Rep. .

Abstract

In patients with COPD, it has not been comprehensively assessed whether the predictive value of comorbidities for mortality differs between men and women. We therefore aimed to examine sex differences of COPD comorbidities in regard with prognosis by classifying comorbidities into a comorbidome related to extrapulmonary disorders and a pulmorbidome, referring to pulmonary disorders. The study population comprised 1044 women and 1531 men with the diagnosis of COPD from COSYCONET, among them 2175 of GOLD grades 1-4 and 400 at risk. Associations of comorbidities with mortality were studied using Cox regression analysis for men and women separately. During the follow-up (median 3.7 years) 59 women and 159 men died. In men, obesity, hypertension, coronary artery disease, liver cirrhosis, osteoporosis, kidney disease, anaemia and increased heart rate (HR) predict mortality, in women heart failure, hyperuricemia, mental disorders, kidney disease and increased HR (p < 0.05 each). Regarding the pulmorbidome, significant predictors in men were impairment in diffusion capacity and hyperinflation, in women asthma and hyperinflation. Similar results were obtained when repeating the analyses in GOLD 1-4 patients only. Gender differences should be considered in COPD risk assessment for a tailored approach towards the treatment of COPD.Clinical Trial Registration: ClinicalTrials.gov NCT01245933.

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Conflict of interest statement

PA reports grants from German Federal Ministry of Education and Research (BMBF) Competence Network Asthma and COPD (ASCONET), grants from AstraZeneca GmbH, grants and non-financial support from Bayer Schering Pharma AG, grants, personal fees and non-financial support from Boehringer Ingelheim Pharma GmbH & Co. KG, grants and non-financial support from Chiesi GmbH, grants from GlaxoSmithKline, grants from Grifols Deutschland GmbH, grants from MSD Sharp & Dohme GmbH, grants and personal fees from Mundipharma GmbH, grants, personal fees and non-financial support from Novartis Deutschland GmbH, grants from Pfizer Pharma GmbH, grants from Takeda Pharma Vertrieb GmbH & Co. KG, outside the submitted work. FJF received personal money for adboard activities and lecture fees from Pulmonx, BTG, Olympus and Uptake. CFV reports grants and personal fees from AstraZeneca, grants and personal fees from Boehringer Ingelheim, grants and personal fees from Chiesi, grants and personal fees from GlaxoSmithKline, grants and personal fees from Grifols, grants and personal fees from Novartis, personal fees from Berlin Chemie/Menarini, personal fees from CSL Behring, grants from German Federal Ministry of Education and Research (BMBF) Competence Network Asthma and COPD (ASCONET), personal fees from Nuvaira, personal fees from MedUpdate, outside the submitted work. HUK reports grants from Siemens, non-financial support from Bayer, during the conduct of the study; grants from Siemens, grants and personal fees from Philips, personal fees from Boehringer Ingelheim, personal fees from Merck Sharp Dohme, personal fees from Astra Zeneca, outside the submitted work. J.W. reports grants from German Ministry of Research and Education, grants from AstraZeneca, GSK, Novartis, Boehringer, during the conduct of the study. R.B. reports grants and personal fees from AstraZeneca, grants and personal fees from Boehringer Ingelheim, personal fees from GlaxoSmithKline, personal fees from Grifols, grants and personal fees from Novartis, personal fees from CSL Behring, grants from German Federal Ministry of Education and Research (BMBF) Competence Network Asthma and COPD (ASCONET), grants from Sander Stiftung, grants from Schwiete Stiftung, grants from Krebshilfe, grants from Mukoviszidose eV, outside the submitted work. FCT, RJ, JW, HW, AK, ML, JB, AT, and KK have nothing to disclose.

Figures

Figure 1
Figure 1
The left panel of this figure refers to men, the right panel to women. Each panel shows the hazard ratio as well as the prevalence of the comorbidities analyzed. Statistically significant associations (p < 0.05) are indicated by filled circles, those being not significant by open circles. Comorbidities that are part of the comorbidome are marked in red, those of the pulmorbidome in blue. The area of each circle represents the prevalence in the respective population. The dotted circle indicates a hazard ratio of 1. The distance of comorbidities from the circle and its center indicates the magnitude of the hazard ratio (see Supplemental Tables S1–S4), with hazard ratios greater than 1 plotted inwards and hazard ratios less than 1 outwards. This inverse type of plot was chosen to keep the figure compact.
See this image and copyright information in PMC

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