A combined pulmonary function and emphysema score prognostic index for staging in Chronic Obstructive Pulmonary Disease
| Autor: | Afroditi K, Boutou, Arjun, Nair, Dariush, Douraghi-Zadeh, Ranbir, Sandhu, David M, Hansell, Athol U, Wells, Michael I, Polkey, Nicholas S, Hopkinson |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Pulmonology Epidemiology Clinical Research Design Chronic Obstructive Pulmonary Disease Neuroimaging Kaplan-Meier Estimate Biostatistics Research and Analysis Methods Diagnostic Radiology Pulmonary Disease Chronic Obstructive Risk Factors Diagnostic Medicine Confidence Intervals Medicine and Health Sciences Humans Clinical Epidemiology Prospective Studies Proportional Hazards Models Retrospective Studies Radiology and Imaging Biology and Life Sciences Middle Aged Prognosis respiratory tract diseases Respiratory Function Tests Computed Axial Tomography Pulmonary Emphysema Research Design Physical Sciences Female Mathematics Statistics (Mathematics) Research Article Neuroscience |
| Zdroj: | PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | Introduction Chronic Obstructive Pulmonary Disease (COPD) is characterized by high morbidity and mortality. Lung computed tomography parameters, individually or as part of a composite index, may provide more prognostic information than pulmonary function tests alone. Aim To investigate the prognostic value of emphysema score and pulmonary artery measurements compared with lung function parameters in COPD and construct a prognostic index using a contingent staging approach. Material-Methods Predictors of mortality were assessed in COPD outpatients whose lung computed tomography, spirometry, lung volumes and gas transfer data were collected prospectively in a clinical database. Univariate and multivariate Cox proportional hazard analysis models with bootstrap techniques were used. Results 169 patients were included (59.8% male, 61.1 years old; Forced Expiratory Volume in 1 second % predicted: 40.5±19.2). 20.1% died; mean survival was 115.4 months. Age (HR = 1.098, 95% Cl = 1.04–1.252) and emphysema score (HR = 1.034, 95% CI = 1.007–1.07) were the only independent predictors of mortality. Pulmonary artery dimensions were not associated with survival. An emphysema score of 55% was chosen as the optimal threshold and 30% and 65% as suboptimals. Where emphysema score was between 30% and 65% (intermediate risk) the optimal lung volume threshold, a functional residual capacity of 210% predicted, was applied. This contingent staging approach separated patients with an intermediate risk based on emphysema score alone into high risk (Functional Residual Capacity ≥210% predicted) or low risk (Functional Residual Capacity |
| Databáze: | OpenAIRE |
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