The risk of stroke is higher among older adults with COPD if they are Black or Hispanic, live in lower-income areas and/or currently smoke.
That’s according to a paper, “Sociodemographic Differences in Clinical Phenotypes Among Patients With COPD: A Latent Class Analysis,” published in BMJ Open Respiratory Research.
In this retrospective cohort study, researchers looked at 57,797 adults aged 50 to 80 years with COPD at an academic medical center in north-central Florida. Latent class analysis defined COPD clinical phenotypes using indicators of clinical severity, including:
- Frequency of acute care encounters (urgent care, emergency department visits and hospitalizations)
- Presence of COPD as a primary diagnosis
- Comorbidity burden
- Use of Global Initiative for COPD Group E (formerly Group D) medications, including dual bronchodilation and triple therapy
The researchers assessed mortality across phenotypes using Kaplan-Meier survival curves and Cox proportional hazard models and identified five clinical phenotypes: minimal, mild, moderate, severe and very severe.
The very severe phenotype had the highest mortality rate, and the odds of very severe COPD were found to be higher among non-Hispanic Black and Hispanic individuals compared with other groups. Odds were also higher in those who reside in rural or lowest income communities and those who currently smoke.
The researchers concluded that, although the phenotypes do not replace spirometry or patient-reported measures in terms of diagnosis and risk prediction, they can be used to provide insight into how COPD is expressed within the health care system to identify populations that are at an elevated risk.
