Background: COPD is a major cause of morbidity and mortality. Despite this, there are very little data regarding COPD mortality in Central and Eastern Europe (CEE). The Phenotypes of COPD in Central and Eastern Europe (POPE) study outlined four clinical COPD phenotypes in patients from the CEE region. Here, RETRO-POPE compared mortality in two independent POPE study cohorts. 
Methods: RETRO-POPE retrospectively assessed mortality in patients with COPD from the Czech Republic (CZ) and Serbia (SRB) 7 years after the POPE study. Patients were assigned to predefined phenotypes according to their clinical characteristics, or into five clusters based on comorbidities, lung function, age, body mass index and dyspnea (Burgel’s clustering), and their survival status was assessed.  Results: Overall, 1,003 POPE study patients were assessed for inclusion in the RETRO-POPE analysis, of whom 801 patients had sufficient data for analysis. At the time of data collection, 440 patients (54.9%) were alive and 361 had died (45.1%). When mortality was assessed by phenotype, no significant differences were seen. In the CZ, separation in mortality was seen between phenotypes (P=0.009), whereas in SRB, death seemed to be more independent of phenotype (P=0.479). Burgel’s clustering of patients distinguished between mortality more than when stratified by phenotypes. Patients in SRB were found to have a greater long-term overall survival than patients in the CZ. Conclusion: RETRO-POPE found that clusters based on comorbidities, lung function, age, body mass index and dyspnea were more likely to show an association with mortality risk than phenotypes according to exacerbation history and presence or absence of chronic bronchitis and asthma features.