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All-cause and cause-specific mortality in respiratory symptom clusters: a population-based multicohort study
Daniil Lisik1, Helena Backman2, Hannu Kankaanranta3,4,5
1Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. daniil.lisik@gu.se.
Respiratory Research
|April 16, 2025
Summary
Common respiratory symptoms in adults form distinct clusters, some significantly increasing mortality risk. Identifying these symptom groups is crucial for understanding health outcomes and potential undiagnosed conditions.
Area of Science:
- Epidemiology
- Respiratory Medicine
- Biostatistics
Background:
- Respiratory symptoms are prevalent in the general adult population.
- A higher burden of respiratory symptoms may be linked to increased mortality risk.
- This study investigates the association between clusters of respiratory symptoms and mortality.
Purpose of the Study:
- To identify distinct clusters of respiratory symptoms in a large adult population.
- To assess the association between these identified symptom clusters and all-cause and cause-specific mortality.
- To determine the clinical relevance of these symptom clusters in relation to diagnosed respiratory diseases.
Main Methods:
- Utilized data from two population-based Swedish adult cohorts (N=63,060).
- Applied Locality Sensitive Hashing (LSH)-k-prototypes for cluster analysis on individuals reporting at least one respiratory symptom.
- Linked mortality register data (over 600,000 person-years) to assess associations, using asymptomatic individuals as the reference group.
Main Results:
- Over 60% reported at least one respiratory symptom; ~30% reported five or more.
- Identified five symptom clusters, including 'low-symptomatic', 'allergic nasal symptoms', 'allergic nasal symptoms with wheezing and dyspnea attacks', 'wheezing and dyspnea attacks', and 'recurrent productive cough and wheezing'.
- All clusters except 'allergic nasal symptoms' were associated with all-cause mortality. Clusters 'wheezing and dyspnea attacks' and 'recurrent productive cough and wheezing' showed the strongest associations with respiratory mortality.
Conclusions:
- Distinct clusters of respiratory symptoms exist within the general adult population.
- These symptom clusters demonstrate clinical relevance by being differentially associated with mortality.
- The identified symptom clusters are only weakly correlated with diagnosed respiratory diseases, suggesting potential for undiagnosed conditions.
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