title: Chronic obstructive pulmonary disease phenotypes using cluster analysis of electronic medical records.
abstract: Chronic obstructive pulmonary disease is a heterogeneous disease. In this retrospective study, we hypothesize that it is possible to identify clinically relevant phenotypes by applying clustering methods to electronic medical records. We included all the patients >40 years with a diagnosis of chronic obstructive pulmonary disease admitted to the University of New Mexico Hospital between 1 January 2011 and 1 May 2014. We collected admissions, demographics, comorbidities, severity markers and treatments. A total of 3144 patients met the inclusion criteria: 46 percent were >65 years and 52 percent were males. The median Charlson score was 2 (interquartile range: 1-4) and the most frequent comorbidities were depression (36%), congestive heart failure (25%), obesity (19%), cancer (19%) and mild liver disease (18%). Using the sphere exclusion method, nine clusters were obtained: depression-chronic obstructive pulmonary disease, coronary artery disease-chronic obstructive pulmonary disease, cerebrovascular disease-chronic obstructive pulmonary disease, malignancy-chronic obstructive pulmonary disease, advanced malignancy-chronic obstructive pulmonary disease, diabetes mellitus-chronic kidney disease-chronic obstructive pulmonary disease, young age-few comorbidities-high readmission rates-chronic obstructive pulmonary disease, atopy-chronic obstructive pulmonary disease, and advanced disease-chronic obstructive pulmonary disease. These clusters will need to be validated prospectively.
authors.affiliation: University of New Mexico School of Medicine, USA.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Vazquez Guillamet
authors.affiliation: University of New Mexico School of Medicine, USA.
authors.forename: Oleg
authors.initials: O
authors.lastname: Ursu
authors.affiliation: University of New Mexico School of Medicine, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Iwamoto
authors.affiliation: University of New Mexico School of Medicine, USA.
authors.forename: Pope L
authors.initials: PL
authors.lastname: Moseley
authors.affiliation: University of New Mexico School of Medicine, USA.
authors.forename: Tudor
authors.initials: T
authors.lastname: Oprea
mesh_terms: D000368:Aged; D015897:Comorbidity; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010641:Phenotype; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: asthma; chronic obstructive pulmonary disease; comorbidity; epidemiology; factor analysis; phenotype