The DOI matches its Crossref record; 52 of the 52 references it cites were found in a registry or an index.
Clusters of Comorbidities Based on Validated Objective Measurements and Systemic Inflammation in Patients with Chronic Obstructive Pulmonary Disease
Abstract
RATIONALE: Comorbidities contribute to disease severity and mortality in patients with chronic obstructive pulmonary disease (COPD). Comorbidities have been studied individually and were mostly based on self-reports. The coexistence of objectively identified comorbidities and the role of low-grade systemic inflammation in the pathophysiology of COPD remain to be elucidated. OBJECTIVES: To cluster 13 clinically important objectively identified comorbidities, and to characterize the comorbidity clusters in terms of clinical outcomes and systemic inflammation. METHODS: A total of 213 patients with COPD (FEV1, 51 ± 17% predicted; men, 59%; age, 64 ± 7 yr) were included prospectively. Comorbidities were based on well-known cut-offs identified in the peer-reviewed English literature. Systemic inflammatory biomarkers were determined in all patients. Self-organizing maps were used to generate comorbidity clusters. MEASUREMENTS AND MAIN RESULTS: A total of 97.7% of all patients had one or more comorbidities and 53.5% had four or more comorbidities. Five comorbidity clusters were identified: (1) less comorbidity, (2) cardiovascular, (3) cachectic, (4) metabolic, and (5) psychological. Comorbidity clusters differed in health status but were comparable with respect to disease severity. An increased inflammatory state was observed only for tumor necrosis factor (TNF) receptors in the metabolic cluster (geometric mean [lower and upper limit]; TNF-R1, 2,377 [1,850, 3,055] pg/ml, confidence, 98.5%; TNF-R2, 4,080 [3,115, 5,344] pg/ml, confidence, 98.8%) and only for IL-6 in the cardiovascular cluster (IL-6, 3.4 [1.8, 6.6] pg/ml; confidence, 99.8%). CONCLUSIONS: Multimorbidity is common in patients with COPD, and different comorbidity clusters can be identified. Low-grade systemic inflammation is mostly comparable among comorbidity clusters. Increasing knowledge on the interactions between comorbidities increases the understanding of their development and contributes to strategies for prevention or improved treatment.
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The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139
Vestbo, J., Hurd, S. S., Agustí, A. G., Jones, P. W., Vogelmeier, C., Anzueto, A., Barnes, P. J., Fabbri, L. M., Martinez, F. J., Nishimura, M., et al. (2013) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201204-0596pp · Cited by 15,983
(2013) · European Heart Journal · doi:10.1093/eurheartj/eht151 · Cited by 13,655
(2004) · The Lancet · doi:10.1016/s0140-6736(03)15268-3 · Cited by 12,717
Prediction of coronary heart disease using risk factor categories
Wilson, P. W. F., D’Agostino, R. B., Levy, D., Belanger, A. M., Silbershatz, H., & Kannel, W. B. (1998) · Circulation · doi:10.1161/01.cir.97.18.1837 · Cited by 9,581
Barnett, K., Mercer, S. W., Norbury, M., Watt, G., Wyke, S., & Guthrie, B. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60240-2 · Cited by 6,972
Jones, P. W., Quirk, F. H., Baveystock, C. M., & Littlejohns, P. (1992) · American Review of Respiratory Disease · doi:10.1164/ajrccm/145.6.1321 · Cited by 3,035
Bestall, J. C., Paul, E. A., Garrod, R., Garnham, R., Jones, P. W., & Wedzicha, J. A. (1999) · Thorax · doi:10.1136/thx.54.7.581 · Cited by 2,927
Systemic manifestations and comorbidities of COPD
Barnes, P. J., & Celli, B. R. (2009) · European Respiratory Journal · doi:10.1183/09031936.00128008 · Cited by 1,820
Age-Associated Increased Interleukin-6 Gene Expression, Late-Life Diseases, and Frailty
Ershler, W. B., & Keller, E. T. (2000) · Annual Review of Medicine · doi:10.1146/annurev.med.51.1.245 · Cited by 1,282
Cited by
Vogelmeier, C. F., Criner, G. J., Martinez, F. J., Anzueto, A., Barnes, P. J., Bourbeau, J., Celli, B. R., Chen, R., Decramer, M., Fabbri, L. M., et al. (2017) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201701-0218pp · Cited by 3,187
Practitioner’s guide to latent class analysis: Methodological considerations and common pitfalls
Sinha, P., Calfee, C. S., & Delucchi, K. L. (2021) · Critical Care Medicine · doi:10.1097/ccm.0000000000004710 · Cited by 1,204
Chronic obstructive pulmonary disease
Rabe, K. F., & Watz, H. (2017) · The Lancet · doi:10.1016/s0140-6736(17)31222-9 · Cited by 960
Chronic obstructive pulmonary disease
Barnes, P. J., Burney, P. G. J., Silverman, E. K., Celli, B. R., Vestbo, J., Wedzicha, J. A., & Wouters, E. F. M. (2015) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2015.76 · Cited by 734
Self-citationSelf management for patients with chronic obstructive pulmonary disease
Zwerink, M., Brusse-Keizer, M., van der Valk, P. D., Zielhuis, G. A., Monninkhof, E. M., van der Palen, J., Frith, P. A., & Effing, T. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002990.pub3 · Cited by 572
Metadata
- Authors
- Vanfleteren, L. E. G. W., Spruit, M. A., Groenen, M., Gaffron, S., van Empel, V. P. M., Bruijnzeel, P. L. B., Rutten, E. P. A., Op ’t Roodt, J., Wouters, E. F. M., & Franssen, F. M. E.
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-04-01
- Volume
- 187
- Issue
- 7
- Pages
- 728-735
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W1973597670
- Cited by
- 828
- References
- 52
- FWCI
- 61.14
- Type
- journal article
- Language
- en
- Open access
- closed
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- Vanfleteren, L. E. G. W., Spruit, M. A., Groenen, M., Gaffron, S., van Empel, V. P. M., Bruijnzeel, P. L. B., Rutten, E. P. A., Op ’t Roodt, J., Wouters, E. F. M., & Franssen, F. M. E. (2013). Clusters of Comorbidities Based on Validated Objective Measurements and Systemic Inflammation in Patients with Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine. https://doi.org/10.1164/rccm.201209-1665oc
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