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Development and Validation of a Predictive Nomogram for Progression from Pre-COPD to Spirometric COPD: A Multicenter
Jiaxuan Wu1,2,3,4,5, Huohuo Zhang1,2,3,4,5, Lan Yang1,2,3,4,5
1Department of Pulmonary and Critical Care Medicine, West China Hospital, State Key Laboratory of Respiratory Health and Multimorbidity, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Summary
Early identification of pre-chronic obstructive pulmonary disease (pre-COPD) is crucial. A new nomogram identifies age, hypertension, diabetes, hemoglobin, lymphocyte, and basophil counts as key risk factors for COPD progression.
Area of Science:
- Pulmonary Medicine
- Clinical Epidemiology
- Biostatistics
Background:
- Pre-chronic obstructive pulmonary disease (pre-COPD) affects many individuals, yet practical tools for predicting progression to spirometry-defined COPD are lacking.
- Early identification is vital to prevent irreversible lung damage and manage disease progression effectively.
Purpose of the Study:
- To identify independent risk factors for COPD progression in a pre-COPD population.
- To develop and validate a clinical nomogram for quantifying the risk of disease progression.
Main Methods:
- A multicenter, retrospective cohort study involving 1088 pre-COPD participants in Southwest China (2019-2023).
- Analysis of baseline demographic data, smoking status, comorbidities, lung function, and hematological/biochemical indicators.
- Multivariate logistic regression for identifying independent predictors and constructing/validating a risk-prediction nomogram.
Main Results:
- Over half (54.6%) of participants progressed to COPD during follow-up.
- Six independent risk factors identified: age, hypertension, diabetes, hemoglobin, lymphocyte count, and basophil count.
- The nomogram showed strong discriminative ability (AUC 0.758 training, 0.718 validation) with good calibration and clinical net benefit.
Conclusions:
- Progression from pre-COPD to COPD is common, influenced by age, comorbidities, and systemic inflammation markers.
- The validated nomogram serves as a precise, non-invasive tool for identifying high-risk individuals.
- This facilitates targeted early intervention and optimizes resource allocation for COPD prevention.
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