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


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
doi: 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:

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


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