Evaluation of clinical phenotypic characteristics in patients with chronic obstructive pulmonary disease

In our study, we have aimed to determinate clinical phenotypic characteristics and to find similar and different aspect of COPD cases.Method: 202 COPD cases that routine follow up or newly diagnosed in Dokuz Eylul University School of Medicine Pulmonary Diseases Department were included the study. Age, cumulative smoking, exacerbations, body mass index (BMI), spirometric values, blood C-reactive protein levels and comorbidies of cases were determinated. Short Form 36 (SF-36) and Beck anxiety scale were performed to all cases. Dyspnea index of patients determined with Modified Medical Research Council (MMRC) scale.Patient classification was performed using hierarchical cluster analysis and Phenotypes that differ from each other were determined.Results: Cluster analysis resulted in the classification of subjects into four clinical phenotypes defined as old/severe/overweight, old/severe/normal weight, young/mild/normal weight and old/mild/owerweight. Despite the similarity of spirometric values between the phenotypes of some groups dyspnea scores and quality of life data were different. Frequencies of exacerbations were found to affect the quality of life and anxiety in a negative way. We have seen that concomitant cardiovascular diseases reduce the quality of life and increase the degree of dyspnea even in similar spirometric values. Women cases have worse mental component of life quality and higher anxiety than males even in similar conditions.Conclusion: Multiple variables like exacerbation rate, gender, comorbidies, anxiety and life quality must be taken into consideration during the COPD management and phenotypic groupings, be investigated by clinical practice.Key Words: chronic obstructive pulmonary disease, clinical phenotypes, quality of life, anxiety, dyspnea index, exacerbation