Identification of five clusters of comorbidities in a longitudinal Japanese chronic obstructive pulmonary disease cohort

Chubachi, Shotaro; Sato, Minako; Kameyama, Naofumi; Tsutsumi, Atsushi; Sasaki, Makoto; Tateno, Hiroki; Nakamura, Hidetoshi; Asano, Koichiro; Betsuyaku, Tomoko

doi:10.1016/j.rmed.2016.07.002

Cited by 35 publications

(35 citation statements)

References 40 publications

(40 reference statements)

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“…Therefore, we considered asthma patients with CAO but a low smoking history not to be ACO under the proposed criteria. The reported vascular diseases as a comorbidity of COPD are markedly lower in Japan than in other countries, 31 – 33 and the data of this study were consistent with those of a recent study in Japan. 31 …”

Section: Discussionsupporting

confidence: 92%

Smoking history and emphysema in asthma–COPD overlap

Kurashima¹,

Takaku²,

Ohta³

et al. 2017

COPD

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BackgroundEmphysema is a distinct feature for classifying COPD, and smoking history (≥10 pack-years) is one of several newly proposed criteria for asthma–COPD overlap (ACO). We studied whether or not a smoking history (≥10 pack-years) and emphysema are useful markers for classifying ACO and differentiating it from asthma with chronic airflow obstruction (CAO).MethodsWe retrospectively studied the mortalities and frequencies of exacerbation in 256 consecutive patients with ACO (161 with emphysema and 95 without emphysema) who had ≥10 pack-years smoking history, 64 asthma patients with CAO but less of a smoking history (<10 pack-years) and 537 consecutive patients with COPD (452 with emphysema and 85 without emphysema) from 2000 to 2016. In the patients with emergent admission, the causes were classified into COPD exacerbation, asthma attack, and others.ResultsNo asthma patients with CAO had emphysema according to computed tomography findings. The prognoses were significantly better in patients with asthma and CAO than in those with ACO and COPD and better in those with ACO than in those with COPD. In both ACO and COPD patients, the prognoses were better in patients without emphysema than in those with it (P=0.027 and P=0.023, respectively). The frequencies of emergent admission were higher in COPD patients than in ACO patients, and higher in patients with emphysema than in patients without emphysema. ACO/emphysema (+) patients experienced more frequent admission due to COPD exacerbation (P<0.001), while ACO/emphysema (−) patients experienced more frequent admission due to asthma attack (P=0.014).ConclusionA smoking history (≥10 pack-years) was found to be a useful marker for differentiating ACO and asthma with CAO, and emphysema was a useful marker for classifying ACO. These markers are useful for predicting the overall survival and frequency of exacerbation.

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Section: Discussionsupporting

confidence: 92%

Smoking history and emphysema in asthma–COPD overlap

Kurashima¹,

Takaku²,

Ohta³

et al. 2017

COPD

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“…Severe COPD exacerbation was defined as one that required hospitalization, including an emergency admission for 24 h [ 24 ]. Comorbid diagnoses were established by clinical history and examination findings based on a review of available medical records [ 20 , 21 , 23 , 24 ].…”

Section: Methodsmentioning

confidence: 99%

Clinical utility of blood neutrophil-lymphocyte ratio in Japanese COPD patients

et al. 2018

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BackgroundNeutrophil-to-lymphocyte ratio (NLR) is a biomarker of inflammation in chronic obstructive pulmonary disease (COPD) patients. But, a meaningful threshold and the longitudinal changes are unknown. We aimed to investigate the association between NLR and the clinical characteristics of COPD patients and to determine a meaningful threshold and the longitudinal changes for NLR.MethodsKeio University and its affiliate hospitals conducted an observational COPD cohort study over 3 years. We performed a blood examination and a pulmonary function test. Blood examination was completed at baseline and annually thereafter, at a time when the disease was stable. Two hundred seventy-four patients who had at least 3 blood examinations over 3 years were included.ResultsBaseline NLR was correlated with baseline C-reactive protein (CRP) (r = 0.18, p = 0.003) and SAA (r = 0.34, p < 0.001). We defined an NLR score of 2.7 as the arbitrary cut-off value based on upper quartile points. COPD patients with NLR ≥ 2.7 were older (p = 0.037), had a lower BMI (p = 0.005) and a lower %FEV1 (p = 0.0003) compared to patients with NLR < 2.7. Receiver-operating-characteristic (ROC) curves showed the optimal cutoff for the baseline NLR in the predicting moderate/severe exacerbation to be 2.7, which was same as the upper quartile points. Follow-up analysis over 3 years revealed that the differences in the trends of NLR among the three groups based on the categories of exacerbations (moderate or severe, mild, no exacerbation) were significant (p = 0.006).ConclusionsNLR is associated with COPD severity and exacerbations. For predicting exacerbations, we estimated the threshold of NLR to be 2.7 at baseline.Trial registrationClinical trial registered with the University Hospital Medication Information Network (UMIN000003470, April 10, 2010).Electronic supplementary materialThe online version of this article (10.1186/s12890-018-0639-z) contains supplementary material, which is available to authorized users.

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“…Independent investigators judged the number and severity of exacerbations based on reviews of physicians' medical records, as previously reported [15]. Comorbid diagnoses were established by clinical history and examination findings based on review of available medical records [12,13,16].…”

Section: Assessment Of Clinical Parametersmentioning

confidence: 99%

Characteristics of patients with increasing COPD assessment test scores within 3 years

Irié

Chubachi

Sato

et al. 2017

Respiratory Medicine

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Identification of five clusters of comorbidities in a longitudinal Japanese chronic obstructive pulmonary disease cohort

Abstract: Five clusters of comorbidities were identified in Japanese COPD patients. The clinical characteristics and health-related quality of life were different among these clusters during a follow-up of two years.

Cited by 35 publications

References 40 publications

Smoking history and emphysema in asthma–COPD overlap

Smoking history and emphysema in asthma–COPD overlap

Clinical utility of blood neutrophil-lymphocyte ratio in Japanese COPD patients

Characteristics of patients with increasing COPD assessment test scores within 3 years

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Identification of five clusters of comorbidities in a longitudinal Japanese chronic obstructive pulmonary disease cohort

Abstract: Five clusters of comorbidities were identified in Japanese COPD patients. The clinical characteristics and health-related quality of life were different among these clusters during a follow-up of two years.

Cited by 35 publications

References 40 publications

Smoking history and emphysema in asthma&ndash;COPD overlap

Smoking history and emphysema in asthma&ndash;COPD overlap

Clinical utility of blood neutrophil-lymphocyte ratio in Japanese COPD patients

Characteristics of patients with increasing COPD assessment test scores within 3 years

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Product

Resources

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Smoking history and emphysema in asthma–COPD overlap

Smoking history and emphysema in asthma–COPD overlap