Using Cluster Analysis to Identify Phenotypes and Validation of Mortality in Men with COPD
Using Cluster Analysis to Identify Phenotypes and Validation of Mortality in Men with COPD
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DOI：
10.1007/s00408-014-9646-x
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发表时间：
2014-12-01
期刊：
影响因子：
5
通讯作者：
Hsiue, Tzuen-Ren
中科院分区：
文献类型：
--
作者：
Chen, Chiung-Zuei;Wang, Liang-Yi;Hsiue, Tzuen-Ren
聚类分析已被提出来检查慢性阻塞性肺疾病（COPD）的表型异质性。本研究的目的是使用聚类分析来定义COPD表型，并通过评估其与死亡率的关系来验证它们。评估了7个变量与COPD的相关性，包括年龄、FEV1%预测值、BMI、重度急性发作史、mMRC、SpO（2）和Charlson指数。通过聚类分析确定COPD组，并对4年随访期间的死亡率进行前瞻性验证。对332例COPD受试者的分析确定了从聚类A到聚类E的5个聚类。对这些COPD聚类的预测有效性的评估显示，聚类E患者的全因死亡率（HR 18.3，p < 0.0001）和呼吸原因死亡率（HR 21.5，p < 0.0001）高于其他四组。聚类E患者的全因死亡率（HR 14.3，p = 0.0002）和呼吸原因死亡率（HR 10.1，p = 0.0013）也高于单独聚类D中的患者。COPD患者严重气流受限，多种症状，以及频繁的严重急性加重史是一种新的和独特的临床表型，可预测COPD男性患者的死亡率。
Cluster analysis has been proposed to examine phenotypic heterogeneity in chronic obstructive pulmonary disease (COPD). The aim of this study was to use cluster analysis to define COPD phenotypes and validate them by assessing their relationship with mortality.Male subjects with COPD were recruited to identify and validate COPD phenotypes. Seven variables were assessed for their relevance to COPD, age, FEV1 % predicted, BMI, history of severe exacerbations, mMRC, SpO(2), and Charlson index. COPD groups were identified by cluster analysis and validated prospectively against mortality during a 4-year follow-up.Analysis of 332 COPD subjects identified five clusters from cluster A to cluster E. Assessment of the predictive validity of these clusters of COPD showed that cluster E patients had higher all cause mortality (HR 18.3, p < 0.0001), and respiratory cause mortality (HR 21.5, p < 0.0001) than those in the other four groups. Cluster E patients also had higher all cause mortality (HR 14.3, p = 0.0002) and respiratory cause mortality (HR 10.1, p = 0.0013) than patients in cluster D alone.COPD patient with severe airflow limitation, many symptoms, and a history of frequent severe exacerbations was a novel and distinct clinical phenotype predicting mortality in men with COPD.