Aim Recently 2 phenotypes of COPD patients treated with home NIV have been identified1. We investigated whether these phenotypes could be reproduced in our cohort and if the change in health-related quality of life (HRQL) differed between these phenotypes.
Method 184 patients with severe COPD and an indication for home NIV were included. 2 clusters of patients were identified using self-organising maps. Change in the Severe Respiratory Insufficiency Questionnaire (SRI) was compared between both clusters.
Results Cluster 1 contained more women compared to cluster 2 (77 vs 57%, p<0.001) and was characterised by lower FEV1 (0.50±0.13 vs 0.69±0.17 L, p<0.001), PaO2 (6.9 vs 7.5 kPa, p=0.01), HRQL (SRI 44.5±11.8 vs 53.5±11.9, p<0.001) and 6 minute walking distance (176±89 vs 268±104 m, p<0.001), and higher RV (5.0±1.3 vs 4.6±1.1 L, p=0.03) and PaCO2 (7.6±1.0 vs 7.0±0.7 kPa, p<0.001). There was a high rate of depression in cluster 1 (71 vs 45%) and higher rates of systemic comorbidities in cluster 2. There was no difference between both clusters in the 6 month change in SRI (total and subdomains) scores (table 1).
Conclusion We could reproduce the previously identified respiratory and systemic phenotypes but these phenotypes do not respond differently in term of change in HRQL.
1 Jansens, Respiration 2022
| Table 1 6-month change in the SRI | |||
| Cluster 1 | Cluster 2 | p-value1 | |
| SRI sum score | 3.5±10.4 | 4.1±11.9 | 0.73 |
| Respiratory complaints | 6.0±11.8 | 7.9±15.3 | 0.39 |
| Physical functioning | -0.2±14.2 | 1.0±17.4 | 0.63 |
| Attendant symptoms | 8.4±15.9 | 7.8±15.6 | 0.81 |
| Social relationships | 1.7±12.8 | 1.8±13.3 | 0.97 |
| Anxiety | 6.3±18.9 | 6.0±21.1 | 0.92 |
| Well-being | 2.5±16.4 | 1.4±16.7 | 0.68 |
| Social functioning | -0.3±15.9 | 1.4±16.9 | 0.53 |
| 1 Independent samples t-test | |||