Supplementary tables and figures

Supplementary table 1. Clinical codes (Read/OXMIS terms) used to define COPD GPRD Medical Code Read/OXMIS Code Read/OXMIS Term 303970 491 Chronic 303973 492 Emphysema pulmonary 303971 491 AC Bronchitis acute on chronic 275013 491 BT Bronchitis obstructive 303972 491 E Chronic bronchitis with emphysema 306529 491 R Bronchitis recurrent 265866 492 AB Apical bullae 265867 492 AC Emphysema apical bullae 306530 492 CM Hyperinflation compensatory 256647 492 PP Puffer pink 304065 5199C Obstructive airways disease 304067 5199CL Obstructive disease 304071 5199G Obstructive airways disease chronic 304072 5199GE Exacerbation coad 304073 5199GL COLD (chronic obstructive lung disease) 304074 5199GP COPD (chronic obstructive pulmonary disease) 305740 9906E Radiological emphysema 280081 H3...00 Chronic obstructive pulmonary disease 243388 H3...11 Chronic obstructive airways disease 207194 H31..00 Chronic bronchitis 280085 H310.00 Simple chronic bronchitis 261743 H310000 Chronic catarrhal bronchitis 289195 H310z00 Simple chronic bronchitis NOS 280086 H311.00 Mucopurulent chronic bronchitis 252513 H311000 Purulent chronic bronchitis 271037 H311100 Fetid chronic bronchitis 225243 H311z00 Mucopurulent chronic bronchitis NOS 271038 H312.00 Obstructive chronic bronchitis 280087 H312000 Chronic asthmatic bronchitis 207195 H312011 Chronic wheezy bronchitis 261744 H312100 Emphysematous bronchitis 216142 H312200 Acute exacerbation of chronic obstructive airways disease 252514 H312z00 Obstructive chronic bronchitis NOS 261745 H313.00 Mixed simple and mucopurulent chronic bronchitis 261745 H313.00 Mixed simple and mucopurulent chronic bronchitis 298476 H31y.00 Other chronic bronchitis 261746 H31y100 Chronic tracheobronchitis 225244 H31yz00 Other chronic bronchitis NOS 261747 H31z.00 Chronic bronchitis NOS 234374 H32..00 Emphysema 280088 H320.00 Chronic bullous emphysema 225245 H320000 Segmental bullous emphysema 271039 H320100 Zonal bullous emphysema 225246 H320200 Giant bullous emphysema 271040 H320300 Bullous emphysema with collapse 252516 H320311 Tension pneumatocoele 280089 H320z00 Chronic bullous emphysema NOS 271041 H321.00 Panlobular emphysema 298477 H322.00 Centrilobular emphysema 280090 H32y.00 Other emphysema 280091 H32y000 Acute vesicular emphysema 225247 H32y100 Atrophic (senile) emphysema

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298478 H32y111 Acute interstitial emphysema 216143 H32y200 MacLeod's unilateral emphysema 234375 H32yz00 Other emphysema NOS 234376 H32yz11 Sawyer ‐ Jones syndrome 234377 H32z.00 Emphysema NOS 280094 H36..00 Mild chronic obstructive pulmonary disease 298483 H37..00 Moderate chronic obstructive pulmonary disease 289203 H38..00 Severe chronic obstructive pulmonary disease 207198 H3y..00 Other specified chronic obstructive airways disease 216150 H3y..11 Other specified chronic obstructive pulmonary disease 252524 H3y0.00 Chronic obstruct pulmonary disease with acute lower respiratory infection 252524 H3y0.00 Chronic obstruct pulmonary dis with acute lower respiratory infection 261758 H3y1.00 Chronic obstruct pulmonary dis with acute exacerbation, unspecified 216151 H3z..00 Chronic obstructive airways disease NOS 261759 H3z..11 Chronic obstructive pulmonary disease NOS

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Supplementary tables and figures

Supplementary table 2. Risk factors associated with COPD selected from a literature search Category Variable Restriction*1 Demographic Age At diagnosis information Sex N/A Socioeconomic status*2 N/A Smoking history Current smoker Last recorded before diagnosis Ex‐smoker Last recorded before diagnosis Never smoked Last recorded before diagnosis Comorbidities Before diagnosis Ischaemic heart disease*3 Before diagnosis Heart failure Before diagnosis Stroke Before diagnosis Hyperlipidaemia Before diagnosis Anaemia Before diagnosis Polycythaemia Within 3 years of diagnosis Pulmonary embolus Within 3 years of diagnosis Deep vein thrombosis Within 3 years of diagnosis Atrial fibrillation Before diagnosis Before diagnosis Cancer (excluding lung cancer) Before diagnosis Depression Within 3 years of diagnosis Anxiety Within 3 years of diagnosis Allergic Before diagnosis Tuberculosis Before diagnosis Obstructive sleep apnoea Before diagnosis Gastric ulcer Before diagnosis Helicobacter pylori Before diagnosis Gastro‐oesophageal reflux disease Before diagnosis Osteoporosis Before diagnosis Fractures Before diagnosis Diabetes Before diagnosis Rheumatoid arthritis Before diagnosis Chronic kidney disease Before diagnosis Underweight Within 3 years of diagnosis Cachexia Within 3 years of diagnosis Overweight Within 3 years of diagnosis Obesity Within 3 years of diagnosis Lower infection Within 3 years of diagnosis Upper respiratory tract infection Within 3 years of diagnosis Within 3 years of diagnosis Allergies Before diagnosis Symptoms Within 3 years of diagnosis Dyspnoea Within 3 years of diagnosis Within 3 years of diagnosis Within 3 years of diagnosis Unintentional weight loss Within 3 years of diagnosis, Chronic fatigue or tiredness Within 3 years of diagnosis Insomnia/poor sleep Within 3 years of diagnosis Clinical measurements Height Last recorded before diagnosis and tests Weight Last recorded before diagnosis Body mass index Last recorded before diagnosis Sputum culture Within 3 years of diagnosis Chest X‐ray Within 3 years of diagnosis Medications Within 3 years of diagnosis, Oral prednisolone Within 3 years of diagnosis Antibiotics*4 Within 3 years of diagnosis Consultations GP consultations Within 3 years of diagnosis Emergency hospital referrals Within 3 years of diagnosis *1. Excluding 60 days prior to COPD diagnosis or equivalent matched time point for controls. *2. Socioeconomic status of general practice as measured by the Index of Multiple Deprivation Score.

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*3. Including myocardial infarction, angina & coronary artery bypass graft. *4. Antibiotics (combined): amoxicillin, clarithromycin, doxycyclin, benzylpenicillin, co‐amoxiclav, cefuroxime, or rifampicin

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