COPD Phenotypes and Comorbidities
2017
Introduction: The main objective is to classify phenotypically the COPD patients of the University Hospital of Vic (UHV) according to the GesEPOC Spanish Guide. As a secondary objectives we tried to classify them according to the phenotype/severity, study their comorbidities, evaluate the quality of life and dyspnea according to the phenotype and to analyze the therapeutic adequacy Material and Methods: Non-interventional prospective study of COPD patients with UHV admission between 12/2009-11/2016 Results: 175 cases with 72.7 years. Male 85.7%. FEV1 48.75% and COPD admissions/year 1.44. Smokers 14.9%, former smokers 73.1% and non-smokers 11.4%. Phenotypic classification: non-exacerbator (NE) 40.6%, mixed 8.6%, emphysematous exacerbator (E) 21.1%, chronic bronchitis exacerbator (BC) 29.7%. The relationship between phenotype/severity (Table 1). The relationship between phenotype/comorbidity (Charlson Index (I.Ch)): NE 2.54, mixed 1.73, exacerbator E 1.57, exacerbator BC 2.92. 28% had 2 or more comorbidities (I.Ch) and up to 64% if other pathologies were considered (HTA 55.4%, arrhythmias 24.6%). 17.71% without comorbidity. Impact on quality of life (CAT) and dyspnea (mMRC) (Table 2). Therapeutic adequacy: NE 29.6%, mixed 93.3%, exacerbator E 86.5%, exacerbator BC 84.6% Conclusions: Dominance of NE phenotype was observed. NE and exacerbator BC phenotypes have more comorbidity. High prevalence of pluripathological COPD. Exacerbator E has the greatest impact on quality of life and more dyspnea. A good therapeutic adequacy was observed, except in the NE phenotype due to the abuse of inhaled corticosteroids. All phenotypes present altered quality of life and dyspnea, even non-exacerbator ones
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