title: Heterogeneity in clinical characteristics and co-morbidities in dyspneic individuals with COPD GOLD D: findings of the DICES trial.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous respiratory disease with important extra-pulmonary features and comorbidities. The aim of this study was to assess clinical heterogeneity in a well-defined subgroup of individuals with COPD GOLD D, including possible gender differences.
  
  
  METHODS
  Pulmonary function, arterial blood gases, exercise performance, quadriceps muscle function, problematic activities of daily life, dyspnea, health status and comorbidities have been assessed in 117 individuals with a MRC dyspnea grade 4/5 and COPD GOLD D entering pulmonary rehabilitation.
  
  
  RESULTS
  A broad range of values were found for diffusion capacity, exercise capacity, quadriceps muscle function and health status. Indeed, the high coefficients of variation were found for these outcomes. Problematic activities of daily life as well as objectified comorbidities also varied to a great extent. Moreover, significant gender differences were found for exercise performance, lower-limb muscle function and various comorbidities.
  
  
  CONCLUSIONS
  The current findings emphasize that COPD is a heterogeneous disease whose clinical presentation varies significantly, even in individuals with very severe COPD with the same degree of dyspnea and all classified as GOLD D.
  
  
  BACKGROUND
  NTR2322.
authors.affiliation: Program Development Centre, CIRO+, Centre of Expertise for Chronic Organ Failure, Hornerheide 1, Horn, The Netherlands. mauricesillen@ciro-horn.nl
authors.forename: Maurice J H
authors.initials: MJ
authors.lastname: Sillen
authors.forename: Frits M E
authors.initials: FM
authors.lastname: Franssen
authors.forename: Jeannet M L
authors.initials: JM
authors.lastname: Delbressine
authors.forename: Nicole H M K
authors.initials: NH
authors.lastname: Uszko-Lencer
authors.forename: Lowie E G W
authors.initials: LE
authors.lastname: Vanfleteren
authors.forename: Erica P A
authors.initials: EP
authors.lastname: Rutten
authors.forename: Emiel F M
authors.initials: EF
authors.lastname: Wouters
authors.forename: Martijn A
authors.initials: MA
authors.lastname: Spruit
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000740:Anemia / Q000209:etiology / Q000517:prevention & control; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology; D050171:Dyslipidemias / Q000209:etiology / Q000503:physiopathology; D004417:Dyspnea / Q000209:etiology* / Q000503:physiopathology; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006304:Health Status; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000503:physiopathology; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D052097:Quadriceps Muscle / Q000502:physiology; D051436:Renal Insufficiency, Chronic / Q000209:etiology / Q000503:physiopathology; D012129:Respiratory Function Tests; D012737:Sex Factors
keywords: Chronic obstructive pulmonary disease; Clinical characteristics; Comorbidities