Qualitative emphysema and risk of COPD hospitalization in a multicenter CT lung cancer screening cohort study.

Autor: Gazourian L; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA. Electronic address: Lee.Gazourian@lahey.org., Thedinger WB; Tufts University School of Medicine, Boston, MA, 02111, USA., Regis SM; Department of Radiation Oncology, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA., Pagura EJ; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA., Price LL; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, 02111, USA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, 02111, USA., Gawlik M; Quality and Safety, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA., Stefanescu CF; Department of Pediatrics, Tufts Medical CenterBoston, MA, 02111, USA., Lamb C; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA., Rieger-Christ KM; Translational Research, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA., Singh H; Department of Medicine, Mount Auburn Hospital, Cambridge, MA, 02138, USA., Casasola M; Department of Medicine, Mount Auburn Hospital, Cambridge, MA, 02138, USA., Walker AR; Department of Medicine, Mount Auburn Hospital, Cambridge, MA, 02138, USA., Rupal A; Department of Medicine, Mount Auburn Hospital, Cambridge, MA, 02138, USA., Patel AS; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA., Come CE; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA., Sanayei AM; Tufts University School of Medicine, Boston, MA, 02111, USA., Long WP; Tufts University School of Medicine, Boston, MA, 02111, USA., Rizzo GS; Department of General Surgery, UMass Memorial Medical Center, Worcester, MA, 01655, USA., McKee AB; Department of Radiation Oncology, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA., Washko GR; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA; Applied Chest Imaging Laboratories, Brigham and Women's Hospital, Boston, MA, 02115, USA., San Jose Estepar R; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA; Department of Radiology, Brigham and Women's Hospital Boston, MA, 02115, USA., Wald C; Department of Radiology, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA., McKee BJ; Department of Radiology, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA., Thomson CC; Department of Medicine, Mount Auburn Hospital, Cambridge, MA, 02138, USA; Harvard Medical School, Boston, MA, 02115, USA; Division of Pulmonary and Critical Care Medicine, Mount Auburn Hospital, Cambridge, MA, 02138, USA., Liesching TN; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA.
Jazyk: angličtina
Zdroj: Respiratory medicine [Respir Med] 2021 Jan; Vol. 176, pp. 106245. Date of Electronic Publication: 2020 Nov 20.
DOI: 10.1016/j.rmed.2020.106245
Abstrakt: Background: In the United States, 9 to 10 million Americans are estimated to be eligible for computed tomographic lung cancer screening (CTLS). Those meeting criteria for CTLS are at high-risk for numerous cardio-pulmonary co-morbidities. The objective of this study was to determine the association between qualitative emphysema identified on screening CTs and risk for hospital admission.
Study Design and Methods: We conducted a retrospective multicenter study from two CTLS cohorts: Lahey Hospital and Medical Center (LHMC) CTLS program, Burlington, MA and Mount Auburn Hospital (MAH) CTLS program, Cambridge, MA. CTLS exams were qualitatively scored by radiologists at time of screening for presence of emphysema. Multivariable Cox regression models were used to evaluate the association between CT qualitative emphysema and all-cause, COPD-related, and pneumonia-related hospital admission.
Results: We included 4673 participants from the LHMC cohort and 915 from the MAH cohort. 57% and 51.9% of the LHMC and MAH cohorts had presence of CT emphysema, respectively. In the LHMC cohort, the presence of emphysema was associated with all-cause hospital admission (HR 1.15, CI 1.07-1.23; p < 0.001) and COPD-related admission (HR 1.64; 95% CI 1.14-2.36; p = 0.007), but not with pneumonia-related admission (HR 1.52; 95% CI 1.27-1.83; p < 0.001). In the MAH cohort, the presence of emphysema was only associated with COPD-related admission (HR 2.05; 95% CI 1.07-3.95; p = 0.031).
Conclusion: Qualitative CT assessment of emphysema is associated with COPD-related hospital admission in a CTLS population. Identification of emphysema on CLTS exams may provide an opportunity for prevention and early intervention to reduce admission risk.
(Copyright © 2020 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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