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采用聚类分析对慢性咳嗽的临床表型进行分类。

Clinical phenotypes of chronic cough categorised by cluster analysis.

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea.

Department of Internal Medicine, Hanyang University College of Medicine, Guri, Republic of Korea.

出版信息

PLoS One. 2023 Mar 17;18(3):e0283352. doi: 10.1371/journal.pone.0283352. eCollection 2023.

Abstract

BACKGROUND

Chronic cough is a heterogeneous disease with various aetiologies that are difficult to determine. Our study aimed to categorise the phenotypes of chronic cough.

METHODS

Adult patients with chronic cough were assessed based on the characteristics and severity of their cough using the COugh Assessment Test (COAT) and the Korean version of the Leicester Cough Questionnaire. A cluster analysis was performed using the K-prototype, and the variables to be included were determined using a correlation network.

RESULTS

In total, 255 participants were included in the analysis. Based on the correlation network, age, score for each item, and total COAT score were selected for the cluster analysis. Four clusters were identified and characterised as follows: 1) elderly with mild cough, 2) middle-aged with less severe cough, 3) relatively male-predominant youth with severe cough, and 4) female-predominant elderly with severe cough. All clusters had distinct demographic and symptomatic characteristics and underlying causes.

CONCLUSIONS

Cluster analysis of age, score for each item, and total COAT score identified 4 distinct phenotypes of chronic cough with significant differences in the aetiologies. Subgrouping patients with chronic cough into homogenous phenotypes could provide a stratified medical approach for individualising diagnostic and therapeutic strategies.

摘要

背景

慢性咳嗽是一种病因多样且难以确定的异质性疾病。本研究旨在对慢性咳嗽的表型进行分类。

方法

根据咳嗽评估测试(COAT)和韩国莱斯特咳嗽问卷的特点和严重程度,对慢性咳嗽的成年患者进行评估。使用 K-原型进行聚类分析,并使用相关网络确定要包含的变量。

结果

共有 255 名参与者纳入分析。基于相关网络,选择年龄、每个项目的评分和总 COAT 评分进行聚类分析。确定了 4 个聚类,其特征如下:1)老年患者,咳嗽较轻;2)中年患者,咳嗽程度较轻;3)相对以男性为主的青年患者,咳嗽严重;4)以女性为主的老年患者,咳嗽严重。所有聚类均具有明显的人口统计学和症状特征以及潜在病因。

结论

对年龄、每个项目的评分和总 COAT 评分进行聚类分析,确定了慢性咳嗽的 4 种不同表型,其病因有显著差异。将慢性咳嗽患者分为同质表型,可以为个体化诊断和治疗策略提供分层医疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c36b/10022767/7ec2d209ddcc/pone.0283352.g001.jpg

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