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Comorbidities and Risk of Mortality in Patients with Chronic Obstructive Pulmonary Disease

Divo, Miguel, Cote, Claudia, de Torres, Juan P., Casanova, Ciro, Marin, Jose M., Pinto-Plata, Victor, Zulueta, Javier, Cabrera, Carlos, Zagaceta, Jorge, Hunninghake, Gary, Celli, Bartolome, for the BODE Collaborative Group·2012·American Journal of Respiratory and Critical Care Medicine

Abstract

RATIONALE: Patients with chronic obstructive pulmonary disease (COPD) are afflicted by comorbidities. Few studies have prospectively evaluated COPD comorbidities and mortality risk. OBJECTIVES: To prospectively evaluate COPD comorbidities and mortality risk. METHODS: We followed 1,664 patients with COPD in five centers for a median of 51 months. Systematically, 79 comorbidities were recorded. We calculated mortality risk using Cox proportional hazard, and developed a graphic representation of the prevalence and strength of association to mortality in the form of a "comorbidome". A COPD comorbidity index (COPD specific comorbidity test [COTE]) was constructed based on the comorbidities that increase mortality risk using a multivariate analysis. We tested the COTE index as predictor of mortality and explored whether the COTE index added predictive information when used with the validated BODE index. MEASUREMENTS AND MAIN RESULTS: Fifteen of 79 comorbidities differed in prevalence between survivors and nonsurvivors. Of those, 12 predicted mortality and were integrated into the COTE index. Increases in the COTE index were associated with an increased risk of death from COPD-related (hazard ratio [HR], 1.13; 95% confidence interval, 1.08-1.18; P < 0.001) and non-COPD-related causes (HR, 1.18; 95% confidence interval, 1.15-1.21; P < 0.001). Further, increases in the BODE and COTE were independently associated with increased risk of death. A COTE score of greater than or equal to 4 points increased by 2.2-fold the risk of death (HR, 2.26-2.68; P < 0.001) in all BODE quartile. CONCLUSIONS: Comorbidities are frequent in COPD and 12 of them negatively influence survival. A simple disease-specific comorbidities index (COTE) helps assess mortality risk in patients with COPD.

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Metadata

Authors
Divo, M., Cote, C., de Torres, J. P., Casanova, C., Marin, J. M., Pinto-Plata, V., Zulueta, J., Cabrera, C., Zagaceta, J., Hunninghake, G., Celli, B., & for the BODE Collaborative Group
Venue
American Journal of Respiratory and Critical Care Medicine
Published
2012-07-15
Volume
186
Issue
2
Pages
155-161
ISSN
  • 1073-449X (ISSN-L)
  • 1535-4970
OpenAlex
W2139503178
Cited by
1,275
References
7
FWCI
65.69
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Comorbidities and Risk of Mortality in Patients with Chronic Obstructive Pulmonary Disease. https://app.cochat.ai/papers/10.1164/rccm.201201-0034oc
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Divo, M., Cote, C., de Torres, J. P., Casanova, C., Marin, J. M., Pinto-Plata, V., Zulueta, J., Cabrera, C., Zagaceta, J., Hunninghake, G., Celli, B., & for the BODE Collaborative Group. (2012). Comorbidities and Risk of Mortality in Patients with Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine. https://doi.org/10.1164/rccm.201201-0034oc

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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