{
    "abstract": "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.\nParticipants were derived from two population-based Swedish adult cohorts (N\u2009=\u200963,060). Cluster analysis was performed with Locality Sensitive Hashing (LSH)-k-prototypes in subjects with\u2009\u2265\u20091 self-reported respiratory symptom. Linked mortality register data (up to 21\u00a0years of follow-up,\u2009>\u2009600,000 person-years) were used. Associations between clusters and all-cause/cause-specific mortality were assessed using asymptomatic subjects as reference.\nOver 60% reported \u2265\u20091 respiratory symptom and ~\u200930% reported \u2265\u20095 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.\nRespiratory 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.",
    "authors": [
        {
            "affiliation": "Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. daniil.lisik@gu.se.",
            "firstname": "Daniil",
            "initials": "D",
            "lastname": "Lisik"
        },
        {
            "affiliation": "Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Ume\u00e5 University, Ume\u00e5, Sweden.",
            "firstname": "Helena",
            "initials": "H",
            "lastname": "Backman"
        },
        {
            "affiliation": "Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.\nTampere University Respiratory Research Group, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.\nDepartment of Respiratory Medicine, Sein\u00e4joki Central Hospital, Sein\u00e4joki, Finland.",
            "firstname": "Hannu",
            "initials": "H",
            "lastname": "Kankaanranta"
        },
        {
            "affiliation": "Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.\nDivision of Geriatric Medicine, Department of Clinical Sciences in Malm\u00f6, Lund University, Malm\u00f6, Sweden.",
            "firstname": "Rani",
            "initials": "R",
            "lastname": "Basna"
        },
        {
            "affiliation": "Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Ume\u00e5 University, Ume\u00e5, Sweden.",
            "firstname": "Linnea",
            "initials": "L",
            "lastname": "Hedman"
        },
        {
            "affiliation": "Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.",
            "firstname": "Linda",
            "initials": "L",
            "lastname": "Ekerljung"
        },
        {
            "affiliation": "School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.",
            "firstname": "Fredrik",
            "initials": "F",
            "lastname": "Nyberg"
        },
        {
            "affiliation": "Department of Public Health and Clinical Medicine, The OLIN Unit, Ume\u00e5 University, Ume\u00e5, Sweden.",
            "firstname": "Anne",
            "initials": "A",
            "lastname": "Lindberg"
        },
        {
            "affiliation": "Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.",
            "firstname": "G\u00f6ran",
            "initials": "G",
            "lastname": "Wennergren"
        },
        {
            "affiliation": "Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Ume\u00e5 University, Ume\u00e5, Sweden.",
            "firstname": "Eva",
            "initials": "E",
            "lastname": "R\u00f6nmark"
        },
        {
            "affiliation": "Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.\nWallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.",
            "firstname": "Bright",
            "initials": "B",
            "lastname": "Nwaru"
        },
        {
            "affiliation": "COPD Center, Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden.\nDepartment of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.",
            "firstname": "Lowie",
            "initials": "L",
            "lastname": "Vanfleteren"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2025. The Author(s).",
    "doi": "10.1186/s12931-025-03224-7",
    "journal": "Respiratory research",
    "keywords": [
        "Cluster analysis",
        "Cough",
        "Dyspnea",
        "Machine learning",
        "Mortality",
        "Respiratory symptoms",
        "Wheezing"
    ],
    "methods": null,
    "publication_date": "2025-04-17",
    "pubmed_id": "40241067\n25300462\n27238359\n37406781\n1416410\n34740593\n32843179\n36647475\n37703231\n29431517\n24589344\n32745966\n28608416\n12412974\n3558716\n33469380\n28983736\n36264870\n34807953\n30357870\n27217764\n32317829\n25441702\n19821983\n34217049\n27742084\n24000253\n28546280\n10642237",
    "results": "Over 60% reported \u2265\u20091 respiratory symptom and ~\u200930% reported \u2265\u20095 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.",
    "title": "All-cause and cause-specific mortality in respiratory symptom clusters: a population-based multicohort study.",
    "xml": "<Element 'PubmedArticle' at 0x788503ffc130>"
}