{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T08:25:55Z","timestamp":1794385555776,"version":"4.9.0"},"reference-count":30,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T00:00:00Z","timestamp":1686873600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","award":["214667"],"award-info":[{"award-number":["214667"]}],"id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Thorax"],"accepted":{"date-parts":[[2023,5,3]]},"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Identifying correlates of cause-specific mortality in patients with chronic obstructive pulmonary disease (COPD) may aid the targeting of therapies to reduce mortality. We determined factors associated with causes of death in a primary care COPD population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical Practice Research Datalink Aurum was linked to Hospital Episode Statistics and death certificate data. People with COPD alive between 1 January 2010 and 1 January 2020 were included. Patient characteristics were defined before the start of follow-up: (a) frequency and severity of exacerbations; (b) emphysema or chronic bronchitis; (c) Global Obstructive Lung Disease (GOLD) groups A\u2013D; and (d) airflow limitation. We used Cox Proportional Hazards regression and competing risks to investigate the association between patient characteristics and risk of all-cause, COPD and cardiovascular (CV) mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>339\u2009647 people with COPD were included of which 97\u2009882 died during follow-up (25.7% COPD related and 23.3% CV related). Airflow limitation, GOLD group, exacerbation frequency and severity, and COPD phenotype were associated with all-cause mortality. Exacerbations, both increased frequency and severity, were associated with COPD-related mortality (\u22652 exacerbations vs none adjusted HR: 1.64, 1.57\u20131.71; 1 severe vs none adjusted HR: 2.17, 2.04\u20132.31, respectively). Patients in GOLD groups B\u2013D had a higher risk of COPD and CV mortality compared with GOLD group A (GOLD group D vs group A, adjusted HR for COPD mortality: 4.57, 4.23\u20134.93 and adjusted HR for CV mortality: 1.53, 1.41\u20131.65). Increasing airflow limitation was also associated with both COPD and CV mortality (GOLD 4 vs 1, adjusted HR: 12.63, 11.82\u201313.51 and adjusted HR: 1.75, 1.60\u20131.91, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Poorer airflow limitation, worse functional status and exacerbations had substantial associations with risk of all-cause mortality. Differing results for CV and COPD-related mortality suggests interventions to prevent mortality may need to target particular characteristics or time points in the disease course.<\/jats:p><\/jats:sec>","DOI":"10.1136\/thorax-2022-219320","type":"journal-article","created":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T17:20:52Z","timestamp":1686936052000},"page":"202-208","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":48,"title":["Cause-specific mortality in COPD subpopulations: a cohort study of 339 647 people in England"],"prefix":"10.1136","volume":"79","author":[{"given":"Hannah","family":"Whittaker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieran J","family":"Rothnie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0149-4869","authenticated-orcid":false,"given":"Jennifer K","family":"Quint","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,6,16]]},"reference":[{"key":"2024051320324708000_79.3.202.1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.k4680","article-title":"Respiratory disease mortality in the United Kingdom compared with Eu15+ countries in 1985-2015: observational study","volume":"363","author":"Salciccioli","year":"2018","journal-title":"BMJ"},{"key":"2024051320324708000_79.3.202.2","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2018-212514"},{"key":"2024051320324708000_79.3.202.3","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2006.072348"},{"key":"2024051320324708000_79.3.202.4","doi-asserted-by":"crossref","DOI":"10.1038\/srep31893","article-title":"Projecting the COPD population and costs in England and Scotland: 2011 to 2030","volume":"6","author":"McLean","year":"2016","journal-title":"Sci Rep"},{"key":"2024051320324708000_79.3.202.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30925-9"},{"key":"2024051320324708000_79.3.202.6","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1513\/AnnalsATS.201911-820OC","article-title":"Temporal trends in the incidence of heart failure among patients with chronic obstructive pulmonary disease and its association with mortality","volume":"17","author":"Axson","year":"2020","journal-title":"Ann Am Thorac Soc"},{"key":"2024051320324708000_79.3.202.7","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201710-2029OC"},{"key":"2024051320324708000_79.3.202.8","doi-asserted-by":"crossref","unstructured":"Whittaker HR et al . 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