Chest CT-assessed comorbidities and all-cause mortality risk in COPD patients in the BODE cohort.
Chest CT-assessed comorbidities and all-cause mortality risk in COPD patients in the BODE cohort.
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DOI：
10.1111/resp.14223
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发表时间：
2022-04
期刊：
影响因子：
--
通讯作者：
de Torres JP
中科院分区：
文献类型：
--
作者：
Ezponda A;Casanova C;Divo M;Marín-Oto M;Cabrera C;Marín JM;Bastarrika G;Pinto-Plata V;Martin-Palmero Á;Polverino F;Celli BR;de Torres JP
胸部计算机断层扫描（CT）成像的可用性可以帮助诊断与慢性阻塞性肺疾病（COPD）相关的合并症。尚未探索其系统识别及其与全因死亡率的关系。此外，其CT检测的患病率是否与临床诊断不同尚不清楚。在基线时回顾性确定了379例（71%男性）在肺科门诊就诊的轻度至重度COPD患者中10种CT评估的合并症的患病率。记录人体测量学、吸烟史、呼吸困难、肺功能、运动能力、BODE（BMI、阻塞、呼吸困难和运动能力）指数和急性加重率。将CT确定的合并症的患病率与临床记录的患病率进行比较。在中位78个月的观察期内，分析了与全因死亡率的独立相关性。“CT共病组”以图形方式表达了其与死亡风险相关性的强度。冠状动脉钙化、肺气肿和支气管扩张是最常见的合并症（分别为79.8%、62.7%和33.9%）。CT检查前均诊断不足。冠状动脉钙化（风险比[HR] 2.09; 95% CI 1.03-4.26，p = 0.042），支气管扩张（HR 2.12; 95% CI 1.05-4.26，p = 0.036）和腰肌密度低（HR 2.61; 95% CI 1.23-5.57，p = 0.010）与全因死亡率独立相关，并有助于定义“CT合并症”。这项针对COPD患者的研究表明，系统检测10种CT诊断的合并症（其中大多数在临床上未检测到），为患者和临床医生提供了潜在使用信息。这项多中心研究表明，胸部计算机断层扫描（CT）评估10种合并症的存在，检测到这些患者的临床管理中未诊断的重要病理。虽然肺气肿、冠状动脉钙化（CAC）和支气管扩张是最常见的CT检测到的合并症，但CAC、支气管扩张和腰大肌密度低与全因死亡率独立相关。 相关编辑
The availability of chest computed tomography (CT) imaging can help diagnose comorbidities associated with chronic obstructive pulmonary disease (COPD). Their systematic identification and relationship with all‐cause mortality have not been explored. Furthermore, whether their CT‐detected prevalence differs from clinical diagnosis is unknown. The prevalence of 10 CT‐assessed comorbidities was retrospectively determined at baseline in 379 patients (71% men) with mild to severe COPD attending pulmonary clinics. Anthropometrics, smoking history, dyspnoea, lung function, exercise capacity, BODE (BMI, Obstruction, Dyspnoea and Exercise capacity) index and exacerbations rate were recorded. The prevalence of CT‐determined comorbidities was compared with that recorded clinically. Over a median of 78 months of observation, the independent association with all‐cause mortality was analysed. A ‘CT‐comorbidome’ graphically expressed the strength of their association with mortality risk. Coronary artery calcification, emphysema and bronchiectasis were the most prevalent comorbidities (79.8%, 62.7% and 33.9%, respectively). All were underdiagnosed before CT. Coronary artery calcium (hazard ratio [HR] 2.09; 95% CI 1.03–4.26, p = 0.042), bronchiectasis (HR 2.12; 95% CI 1.05–4.26, p = 0.036) and low psoas muscle density (HR 2.61; 95% CI 1.23–5.57, p = 0.010) were independently associated with all‐cause mortality and helped define the ‘CT‐comorbidome’. This study of COPD patients shows that systematic detection of 10 CT‐diagnosed comorbidities, most of which were not detected clinically, provides information of potential use to patients and clinicians caring for them. This multicentric study shows that chest computed tomography (CT) to evaluate the presence of 10 comorbidities detects important pathologies not diagnosed in the clinical management of those patients. While emphysema, coronary artery calcification (CAC) and bronchiectasis were the most prevalent CT‐detected comorbidities, CAC, bronchiectasis and low Psoas muscle density were independently associated with all‐cause mortality. See related Editorial
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影响因子：
8
作者：
de la Rosa Carrillo, David;Luis Lopez-Campos, Jose;Asesor del Documento, Comite
通讯作者：
Asesor del Documento, Comite
影响因子：
2.3
作者：
Ascha M;Renapurkar RD;Tonelli AR
通讯作者：
Tonelli AR
影响因子：
5.8
作者：
Agusti A;Calverley PM;Celli B;Coxson HO;Edwards LD;Lomas DA;MacNee W;Miller BE;Rennard S;Silverman EK;Tal-Singer R;Wouters E;Yates JC;Vestbo J;Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) investigators
通讯作者：
Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) investigators
影响因子：
5.8
作者：
Hersh CP;Washko GR;Estépar RS;Lutz S;Friedman PJ;Han MK;Hokanson JE;Judy PF;Lynch DA;Make BJ;Marchetti N;Newell JD Jr;Sciurba FC;Crapo JD;Silverman EK;COPDGene Investigators
通讯作者：
COPDGene Investigators
影响因子：
24.3
作者：
Celli, Bartolome R.;Locantore, Nicholas;Agusti, Alvar
通讯作者：
Agusti, Alvar