COPD phenotypes: differences in survival

Figures & data

Table 1 General characteristics of the study patients

Parameter	Value
Patients, n	273
Age, years	67.99 (66.72–69.25)
Men, n (%)	243 (89)
BMI, kg/m^2	28.05 (27.40–28.71)
Smoking status, n (%)
Nonsmoker	3 (1.1)
Smoker	92 (33.7)
Ex-smoker	176 (64.5)
Unknown	2 (0.7)
Diabetes mellitus, n (%)	71 (26)
Arterial hypertension, n (%)	146 (53.5)
Dyslipidemia, n (%)	108 (39.6)
Ischemic heart disease, n (%)	38 (13.9)
Atrial fibrillation, n (%)	35 (12.8)
Cerebrovascular accident, n (%)	22 (8.1)
Eosinophils, absolute value	202.93 (185.18–220.68)
Eosinophils, %	2.42 (2.22–2.63)
FEV1, mL	1,221.39 (1,171.76–1,271.02)
FEV1, %	48.64 (47.14–50.14)
Treatment, n (%)
LAMA	254 (93)
LABA	242 (88.6)
Inhaled corticosteroid	212 (77.7)
Roflumilast	7 (2.6)
Theophylline	15 (5.5)
COH	91 (33.5)
CPAP	31 (11.4)
BiPAP	14 (5.1)
Mortality, n (%)	90 (32.9)

Abbreviations: BMI, body mass index; FEV₁, forced expiratory volume in the first second; LABA, long-acting β₂-adrenergic agonists; CPAP, continuous positive airway pressure; BiPAP, bilevel positive airway pressure; COH, continuous home oxygen therapy.

Table 2 Characteristics of the study population by phenotype

Variable	Positive bronchodilator response	Non-exacerbator	Exacerbator with emphysema	Exacerbator with chronic bronchitis	p-value
Patients, n	71	130	36	38
Age, years	63.44 (60.83–66.04)	69.67 (68.07–71.27)	68.44 (64.88–72.01)	71.16 (68.15–74.16)	0.001
Men, n (%)	63 (88.7)	119 (91.5)	31 (86.1)	32 (84.2)	0.558
BMI, kg/m^2	28.15 (26.94–29.36)	28.61 (27.61–29.61)	26.69 (25.06–28.32)	27.01 (25.94–28.08)	0.121
Smoking status, n (%)
Nonsmoker	0 (0)	3 (2.3)	0 (0)	0 (0)	0.336
Smoker	35 (49.3)	35 (27.1)	11 (30.6)	13 (35.1)	0.017
Ex-smoker	36 (50.7)	91 (70.5)	25 (69.4)	24 (64.9)	0.039
Unknown	0 (0)	1 (0.8)	0 (0)	1 (2.6)	0.441
Diabetes mellitus, n (%)	16 (22.5)	32 (24.6)	13 (36.1)	11 (28.9)	0.45
Arterial hypertension, n (%)	28 (39.4)	80 (61.5)	18 (50)	22 (57.9)	0.023
Dyslipidemia, n (%)	24 (33.8)	56 (43.1)	10 (27.8)	12 (31.6)	0.245
Ischemic heart disease, n (%)	4 (5.6)	18 (13.8)	4 (11.1)	14 (36.8)	<0.001
Atrial fibrillation, n (%)	4 (5.6)	18 (13.8)	5 (13.9)	9 (23.7)	0.063
Cerebrovascular accident, n (%)	3 (4.2)	14 (10.8)	3 (8.3)	2 (5.3)	0.373
Eosinophils, absolute value	235.21 (200.11–270.32)	215.38 (190.99–239.78)	150 (111.16–188.84)	118.42 (82.48–154.36)	<0.001
Eosinophils, %	2.73 (2.34–3.12)	2.6 (2.31–2.9)	1.76 (1.33–2.18)	1.58 (1.15–2.02)	<0.001
FEV1, %	53.71 (51.12–56.31)	48.69 (46.57–50.8)	42.31 (38.92–45.7)	42.87 (39.32–46.42)	<0.001
FEV1, mL	1,450.7 (1,358.4–1,543.01)	1,197.62 (1,131.72–1,263.51)	995.56 (912.42–1,078.69)	985.79 (889.16–1,082.42)	<0.001
Mortality, n (%)	12 (16.9)	44 (33.8)	15 (41.7)	19 (50)	0.002
Treatment, n (%)
Anticholinergic drugs	60 (84.5)	124 (95.4)	35 (97.2)	38 (100)	0.004
LABA	66 (93)	107 (82.3)	35 (97.2)	37 (97.4)	0.006
Inhaled corticosteroids	61 (85.9)	87 (66.9)	33 (91.7)	35 (92.1)	<0.001
Roflumilast	2 (2.8)	2 (1.5)	2 (5.6)	1 (2.6)	0.6
Theophylline	1 (1.4)	5 (3.8)	5 (13.9)	6 (15.8)	0.003
COH	14 (19.7)	38 (29.5)	21 (58.3)	24 (63.2)	<0.001
CPAP, BiPAP	10 (14.1)	16 (12.3)	3 (8.3)	2 (5.3)	0.497

Abbreviations: BMI, body mass index; FEV₁, forced expiratory volume in the first second; LABA, long-acting β₂-adrenergic agonists; CPAP, continuous positive airway pressure; BiPAP, bilevel positive airway pressure; COH, continuous home oxygen therapy.

Table 3 Cause of death according to phenotype

Cause	Total		Positive bronchodilator response		Non-exacerbator		Exacerbator with emphysema		Exacerbator with chronic bronchitis
	n	%	n	%	n	%	n	%	n	%
Acute exacerbation of COPD/pneumonia/respiratory sepsis	42	46.67	5	41.67	18	40.91	9	60	10	52.63
Cancer	23	25.56	4	33.33	11	25	3	20	5	26.32
Heart disease	2	2.22	0	0	2	4.55	0	0	0	0
Other	3	3.33	0	0	1	2.27	1	6.67	1	5.26
Not available	20	22.22	3	25	12	27.27	2	13.33	3	15.79

Table 4 Factors independently associated with mortality (Cox regression)

Variable	Hazard ratio	95% CI	p-value
Age	1.06	1.03–1.09	<0.001
Sex
Female	1
Male	2.10	0.74–5.91	0.158
FEV1	0.98	0.96–0.99	0.044
Phenotype
Positive bronchodilator response	1
Non-exacerbator	1.67	0.87–3.20	0.122
Exacerbator with emphysema	2.04	0.91–4.56	0.079
Exacerbator with chronic bronchitis	3.28	1.53–7.03	0.002

Abbreviation: FEV₁, forced expiratory volume in 1 second.

Figure 1 Kaplan–Meier survival curves according to the phenotype of COPD.

Note: p-value for the comparison of survival curves using the log-rank test.
Abbreviation: NA, not applicable.