The COPD multi-dimensional phenotype: A new classification from the STORICO Italian observational study

English version

Autoři: Raffaele Antonelli Incalzi ^aff001; Giorgio Walter Canonica ^aff002; Nicola Scichilone ^aff003; Sara Rizzoli ^aff004; Lucia Simoni ^aff004; Francesco Blasi ^aff005;
Působiště autorů: University Biomedical Campus of Rome, Rome, Italy ^aff001; Personalized Medicine Asthma & Allergy Clinic Humanitas University Humanitas research Hospital, Rozzano, Milan, Italy ^aff002; DIBIMIS, University of Palermo, Piazza delle Cliniche, Palermo, Italy ^aff003; Medineos Observational Research, Modena, ltaly ^aff004; Department of Pathophysiology and Transplantation, University of Milan, Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center Fondazione IRCCS Cà Granda Maggiore Hospital, Milan, Italy ^aff005
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0221889

Souhrn

Background

This paper is aimed to (i) develop an innovative classification of COPD, multi-dimensional phenotype, based on a multidimensional assessment; (ii) describe the identified multi-dimensional phenotypes.

Methods

An exploratory factor analysis to identify the main classificatory variables and, then, a cluster analysis based on these variables were run to classify the COPD-diagnosed 514 patients enrolled in the STORICO (trial registration number: NCT03105999) study into multi-dimensional phenotypes.

Results

The circadian rhythm of symptoms and health-related quality of life, but neither comorbidity nor respiratory function, qualified as primary classificatory variables. Five multidimensional phenotypes were identified: the MILD COPD characterized by no night-time symptoms and the best health status in terms of quality of life, quality of sleep, level of depression and anxiety, the MILD EMPHYSEMATOUS with prevalent dyspnea in the early-morning and day-time, the SEVERE BRONCHITIC with nocturnal and diurnal cough and phlegm, the SEVERE EMPHYSEMATOUS with nocturnal and diurnal dyspnea and the SEVERE MIXED COPD distinguished by higher frequency of symptoms during 24h and worst quality of life, of sleep and highest levels of depression and anxiety.

Conclusions

Our results showed that properly collected respiratory symptoms play a primary classificatory role of COPD patients. The longitudinal observation will disclose the discriminative and prognostic potential of the proposed multidimensional phenotype.

Trial registration

Trial registration number: NCT03105999, date of registration: 10th April 2017.

Klíčová slova:

Biology and life sciences – Physical sciences – Research and analysis methods – Mathematics – Simulation and modeling – Anatomy – Medicine and health sciences – Pathology and laboratory medicine – Physiology – Diagnostic medicine – Signs and symptoms – Statistics – Mathematical and statistical techniques – Statistical methods – Body fluids – Physiological processes – Pulmonology – Public and occupational health – Physical activity – Applied mathematics – Algorithms – Mucus – Chronic obstructive pulmonary disease – Chronobiology – Factor analysis – Coughing – Dyspnea – Circadian rhythms – Clustering algorithms

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