All-cause and cause-specific mortality in respiratory symptom clusters : a population-based multicohort study
Lisik, Daniil ; Backman, Helena ; Kankaanranta, Hannu ; Basna, Rani LU
; Hedman, Linnea
; Ekerljung, Linda
; Nyberg, Fredrik
; Lindberg, Anne
; Wennergren, Göran
and Rönmark, Eva
, et al.
(2025)
In Respiratory Research
26(1).
- Abstract
Background: Respiratory symptoms are common in the general adult population. Increased burden of respiratory symptoms may increase the risk of mortality. We assessed the association between respiratory symptom clusters and mortality. Methods: Participants were derived from two population-based Swedish adult cohorts (N = 63,060). Cluster analysis was performed with Locality Sensitive Hashing (LSH)-k-prototypes in subjects with ≥ 1 self-reported respiratory symptom. Linked mortality register data (up to 21 years of follow-up, > 600,000 person-years) were used. Associations between clusters and all-cause/cause-specific mortality were assessed using asymptomatic subjects as reference. Results: Over 60% reported ≥ 1 respiratory symptom... (More)
Background: Respiratory symptoms are common in the general adult population. Increased burden of respiratory symptoms may increase the risk of mortality. We assessed the association between respiratory symptom clusters and mortality. Methods: Participants were derived from two population-based Swedish adult cohorts (N = 63,060). Cluster analysis was performed with Locality Sensitive Hashing (LSH)-k-prototypes in subjects with ≥ 1 self-reported respiratory symptom. Linked mortality register data (up to 21 years of follow-up, > 600,000 person-years) were used. Associations between clusters and all-cause/cause-specific mortality were assessed using asymptomatic subjects as reference. Results: Over 60% reported ≥ 1 respiratory symptom and ~ 30% reported ≥ 5 respiratory symptoms. Five clusters were identified, partly overlapping with established respiratory disease phenotypes but many individuals were undiagnosed: (1) "low-symptomatic" (30.3%); (2) "allergic nasal symptoms" (10.7%); (3) "allergic nasal symptoms, wheezing, and dyspnea attacks" (4.7%); (4) "wheezing and dyspnea attacks" (6.6%); (5) "recurrent productive cough and wheezing" (4.1%). All but Cluster 2 were associated with all-cause mortality, highest risk for Cluster 3 (hazard ratio 1.4, 95% confidence interval 1.13–1.73) and Cluster 5 (1.4, 1.22–1.61). Comparable associations were seen for cardiovascular mortality. For respiratory mortality, Cluster 4 (2.02, 1.18–3.46) and Cluster 5 (1.89, 1.1–3.25) were most strongly associated. Conclusions: Respiratory symptoms are common in the general adult population, with identifiable clusters. These clusters have clinical relevancy as they are differentially associated with mortality and relatively weakly correlated with diagnosed respiratory disease.
(Less)
- author
- Lisik, Daniil
; Backman, Helena
; Kankaanranta, Hannu
; Basna, Rani
LU
; Hedman, Linnea
; Ekerljung, Linda
; Nyberg, Fredrik
; Lindberg, Anne
; Wennergren, Göran
and Rönmark, Eva
, et al. (More)
- Lisik, Daniil
; Backman, Helena
; Kankaanranta, Hannu
; Basna, Rani
LU
; Hedman, Linnea
; Ekerljung, Linda
; Nyberg, Fredrik
; Lindberg, Anne
; Wennergren, Göran
; Rönmark, Eva
; Nwaru, Bright
and Vanfleteren, Lowie
(Less)
- organization
- publishing date
- 2025-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cluster analysis, Cough, Dyspnea, Machine learning, Mortality, Respiratory symptoms, Wheezing
- in
- Respiratory Research
- volume
- 26
- issue
- 1
- article number
- 150
- publisher
- BioMed Central (BMC)
- external identifiers
-
- scopus:105002993949
- pmid:40241067
- ISSN
- 1465-9921
- DOI
- 10.1186/s12931-025-03224-7
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © The Author(s) 2025.
- id
- 720b14d3-8e65-4eda-a2a7-e3acf08f51bb
- date added to LUP
- 2025-04-29 10:56:24
- date last changed
- 2025-07-08 17:43:52
@article{720b14d3-8e65-4eda-a2a7-e3acf08f51bb,
abstract = {{<p>Background: Respiratory symptoms are common in the general adult population. Increased burden of respiratory symptoms may increase the risk of mortality. We assessed the association between respiratory symptom clusters and mortality. Methods: Participants were derived from two population-based Swedish adult cohorts (N = 63,060). Cluster analysis was performed with Locality Sensitive Hashing (LSH)-k-prototypes in subjects with ≥ 1 self-reported respiratory symptom. Linked mortality register data (up to 21 years of follow-up, > 600,000 person-years) were used. Associations between clusters and all-cause/cause-specific mortality were assessed using asymptomatic subjects as reference. Results: Over 60% reported ≥ 1 respiratory symptom and ~ 30% reported ≥ 5 respiratory symptoms. Five clusters were identified, partly overlapping with established respiratory disease phenotypes but many individuals were undiagnosed: (1) "low-symptomatic" (30.3%); (2) "allergic nasal symptoms" (10.7%); (3) "allergic nasal symptoms, wheezing, and dyspnea attacks" (4.7%); (4) "wheezing and dyspnea attacks" (6.6%); (5) "recurrent productive cough and wheezing" (4.1%). All but Cluster 2 were associated with all-cause mortality, highest risk for Cluster 3 (hazard ratio 1.4, 95% confidence interval 1.13–1.73) and Cluster 5 (1.4, 1.22–1.61). Comparable associations were seen for cardiovascular mortality. For respiratory mortality, Cluster 4 (2.02, 1.18–3.46) and Cluster 5 (1.89, 1.1–3.25) were most strongly associated. Conclusions: Respiratory symptoms are common in the general adult population, with identifiable clusters. These clusters have clinical relevancy as they are differentially associated with mortality and relatively weakly correlated with diagnosed respiratory disease.</p>}},
author = {{Lisik, Daniil and Backman, Helena and Kankaanranta, Hannu and Basna, Rani and Hedman, Linnea and Ekerljung, Linda and Nyberg, Fredrik and Lindberg, Anne and Wennergren, Göran and Rönmark, Eva and Nwaru, Bright and Vanfleteren, Lowie}},
issn = {{1465-9921}},
keywords = {{Cluster analysis; Cough; Dyspnea; Machine learning; Mortality; Respiratory symptoms; Wheezing}},
language = {{eng}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{Respiratory Research}},
title = {{All-cause and cause-specific mortality in respiratory symptom clusters : a population-based multicohort study}},
url = {{http://dx.doi.org/10.1186/s12931-025-03224-7}},
doi = {{10.1186/s12931-025-03224-7}},
volume = {{26}},
year = {{2025}},
}