Chest
Original ResearchCOPDCT Scan Findings of Emphysema Predict Mortality in COPD
Section snippets
Subjects and Study Design
This study is part of an ongoing COPD follow-up study being performed at Kyoto University (Kyoto, Japan). From regularly treated outpatients with COPD, 251 were enrolled who had CT scans performed at Kyoto University Hospital between April 1995 and April 2005, and their vital statuses as of April 2009 were ascertained. Hospital records were examined to determine the cause of any deaths. When contact with patients was lost, we contacted them or their families by telephone. All deaths were
Baseline Characteristics
Table 1 shows the subjects' baseline characteristics. The number of patients with COPD in each GOLD stage1 was as follows: stage I, 14; stage II, 111; stage III, 90; and stage IV, 36. Because of poor lung function, three subjects did not bear the diffusion capacity test.
Prognostic Research
The median follow-up time as of April 2009 was 2,933 days (range, 215–5,107 days). At the time of analysis, it was not possible to ascertain the vital statuses of 10 of the 251 subjects because they had moved away and could not
Discussion
This study demonstrated that emphysema as assessed by CT imaging is a good predictor of mortality in patients with COPD with various stages of the disease. We documented that increased mortality was independently associated with increased age, higher LAA%, lower BMI, lower FEV1, higher RV/TLC, and lower Dlco/Va. Multivariate analyses indicated that a higher LAA% was associated with mortality independently of increased age, lower BMI, lower FEV1, and lower Dlco/Va. Thus, the extent of emphysema
Conclusions
In conclusion, the extent of emphysema, as assessed by CT scan, is a good predictor of mortality in patients with COPD. This study suggests that CT imaging is a useful tool not only for detecting emphysema but also for predicting mortality in patients with COPD.
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Funding/Support: This study was partially supported by a Grant-in-Aid for scientific research (B) [No. 16390234] and (C) [No. 21590964].
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