Survival of COPD patients according to the new phenotypes defined in Spanish COPD Guidelines 2021

Introduction: The Spanish COPD Guidelines (GesEPOC) has redefined phenotypes in the 2021 update. We analyzed the differences in survival of COPD patients according to the GesEPOC 2021 phenotypes. Methods: Observational study of 273 COPD patients who underwent spirometry in 2011. A sex-year prospective follow-up was performed. The patients were phenotyped using exacerbation and eosinophil data collected in 2011. The difference in survival was analyzed. Results: Of the total of 273 patients, 243 (89.0%) were male. The mean age was 67.99 years (SD 10.62). The mean weight, height and BMI were 75.03 kg (SD 16.87), 1.63 m (SD 0.08) and 28.05 kg/m2 (SD 5.50), respectively. The mean FEV1 was 1221.39 mL (SD 416.55). 93 patients (34.1%) died during follow-up. Regarding phenotypes, 190 patients (69.6%) were non-exacerbators, 69 patients (25.3%) were non-eosinophilic exacerbators, and 14 patients (5.1%) were eosinophilic exacerbators. A lower FEV1 was documented in non-eosinophilic exacerbators (p=0.012). Figure 1 illustrates the survival according to phenotypes. Compared with non-exacerbators, the non-eosinophilic exacerbators had a lower survival, (p=0.009). This difference was not demonstrated in eosinophilic exacerbators (p=0.656). Conclusion: The non-eosinophilic exacerbators had a lower survival compared to non-exacerbators. It’s important to consider this data to offer a more individualized management to patients with COPD.