COPD-specific co-morbidity test (COTE) for predicting mortality in COPD – Results of an European, multicenter study
COPD-specific co-morbidity test (COTE) for predicting mortality in COPD – Results of an European, multicenter study
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用于预测 COPD 死亡率的 COPD 特异性共病测试 (COTE) – 欧洲多中心研究的结果
DOI：
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发表时间：
2014
期刊：
影响因子：
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通讯作者：
M. Tamm
中科院分区：
文献类型：
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作者：
D. Stolz;R. Louis;W. Boersma;B. Milenković;K. Kostikas;F. Blasi;J. Aerts;G. Rohde;A. Marín;L. Boeck;J. Rakic;A. Scherr;A. Torres;T. Welte;M. Tamm
背景：COTE指数描述了影响COPD患者生存的12种合并症。据报道，它补充了BODE指数，从而改善了其生存预测。我们假设COPD的预后系统生物标志物（肾上腺髓质素原和copeptin）可能与COTE指数相关，并且可以进一步改善生存预测。
BACKGROUND: The COTE index describes 12 comorbidities influencing survival in COPD. It reportedly complements the BODE index thereby improving its survival prediction. We hypothesize that prognostic systemic biomarkers in COPD (proadrenomedullin and copeptin) might be associated with the COTE index and could additionally improve survival prediction.
METHODS: We prospectively evaluated 638 patients with stable COPD for ≥ 6 weeks, > 10 PY and GOLD II-IV seeking care in pulmonary tertiary hospitals in 8 European countries and included in the PROMISE cohort. Comorbidities and circulating biomarkers were assessed at baseline. The primary outcome of the study was death from any cause and from respiratory causes. Median observation time was 24 months.
RESULTS: Coronary artery disease and liver cirrhosis presented the strongest association with mortality (p<0.01 for both). There was no association of the COTE index with an increase in the hazard of death (HR 1.060 95% CI 0.964-1.166). Stratification for the follow-up time (< 18 vs ≥ 18months) did not significantly influenced results. Time to death was similar in patients with low (1-3) or high (≥4) COTE index (p=0.364, log-rank). Results were unaffected by stratification for BODE quartiles. Neither proadrenomedulin nor copeptin differed in COTE strata (p=n.s for both). The AUC of proadrenomedullin and copeptin were higher than the one of the COTE index for mortality prediction at 2 years (0.648 and 0.609 versus 0.574).
CONCLUSION: The COPD-specific co-morbidity test (COTE) did not contribute to assess mortality risk in patient with COPD. Neither proadrenomedullin nor copeptin are significantly associated with the COTE index.