March 2014, Vol 145, No.

3_MeetingAbstracts
Obstructive Lung Diseases | March 2014

Clinical Differences Between Patients

With COPD Due to Biomass Smoke or
Tobacco
Pilar Sanjun, MD; Rafael Golpe, PhD; Luis Prez-de-LLano, PhD; Esteban Cano,
MD; Olalla Castro-Aon, MD
Hospital Universitario Lucus Augusti, Lugo, Spain

Chest. 2014;145(3_MeetingAbstracts):421A. doi:10.1378/chest.1808632

Abstract
SESSION TITLE: COPD II
SESSION TYPE: Slide Presentations
PRESENTED ON: Monday, March 24, 2014 at 09:00 AM - 10:00 AM
PURPOSE: Biomass smoke exposure is a risk factor for developing chronic
obstructive pulmonary disease (COPD). Little is currently known concerning clinical
differences between COPD due to tobacco and to biomass smoke. The purpose of this
study was to search for clinical differences between both types of disease
METHODS: Retrospective observational study of 499 patients diagnosed of COPD
due to tobacco or to biomass smoke exposure. Both groups were compared regarding
the prevalence of several predefined clinical phenotypes, severity of the disease
measured using several markers, and weight of comorbidities assessed using the
Charlson and the COTE indices
RESULTS: Three hundred and seventy seven patients (75.5%) were included in the
tobacco group and 122 (24.4%) in the biomass group. There were more males in the
tobacco group (91.2% vs 41.8%, p < 0.0001) and patients were younger in this group
(70.6 vs 76.2 years, p < 0.0001). More patients were classified in GOLD B stage
(29.5% vs 13.5%, p = 0.0001) and less in GOLD D stage (32.8% vs 46.4%, p = 0.01)
in the biomass group than in the tobacco group. BODEX values were lower in the
biomass group. The COPD-plus-asthma phenotype was more prevalent in the biomass
group (21.3% vs 5%, p < 0.0001), although this difference disappeared on adjustment
for sex. The emphysema phenotype was more frequent in the tobacco group (45.9%

vs 31.9%, p = 0.009). The chronic bronchitis and frequent exacerbator phenotypes

were similarly distributed between both groups. The weight of comorbidities and the
rate of hospital admissions were also similar between the biomass and tobacco groups
CONCLUSIONS: There are several clinical differences between patients with
COPD due to tobacco and to biomass smoke exposure, although some of them might
be partially attributable to sex differences between both groups
CLINICAL IMPLICATIONS: The fact that COPD due to biomass smoke has a
different clinical presentation suggests that the natural history, the rate of progression
and the inflammatory pattern might be different to COPD due to tobacco. This fact
might have therapeutic implications. Further studies should be carried out to clarify
this point
DISCLOSURE: Pilar Sanjun: Consultant fee, speaker bureau, advisory committee,
etc.: Almirall, Astra-Zeneca, Boehringer-Ingelheim Rafael Golpe: Consultant fee,
speaker bureau, advisory committee, etc.: Novartis, GSK, Astra-Zeneca, BoehringerIngelheim, Almirall Luis Prez-de-LLano: Grant monies (from industry related
sources): Almirall, Consultant fee, speaker bureau, advisory committee, etc.:
Almirall, Novertis, Astra-Zeneca, Boehringer-Ingelheim, GSK, Menarini Esteban
Cano: Consultant fee, speaker bureau, advisory committee, etc.: GSK Olalla CastroAon: Consultant fee, speaker bureau, advisory committee, etc.: Novartis
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