Department of Pulmonary Medicine, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain.
Divisions of General Internal Medicine and Pulmonary, Critical Care and Pulmonary Medicine, Mount Sinai School of Medicine, New York, NY.
Chest. 2012 May;141(5):1216-1223. doi: 10.1378/chest.11-0101. Epub 2011 Oct 20.
Our objective was to assess the usefulness of emphysema scores in predicting death from COPD and lung cancer.
Emphysema was assessed with low-dose CT scans performed on 9,047 men and women for whom age and smoking history were documented. Each scan was scored according to the presence of emphysema as follows: none, mild, moderate, or marked. Follow-up time was calculated from time of CT scan to time of death or December 31, 2007, whichever came first. Cox regression analysis was used to calculate the hazard ratio (HR) of emphysema as a predictor of death.
Median age was 65 years, 4,433 (49%) were men, and 4,133 (46%) were currently smoking or had quit within 5 years. Emphysema was identified in 2,637 (29%) and was a significant predictor of death from COPD (HR, 9.3; 95% CI, 4.3-20.2; P < .0001) and from lung cancer (HR, 1.7; 95% CI, 1.1-2.5; P = .013), even when adjusted for age and smoking history.
Visual assessment of emphysema on CT scan is a significant predictor of death from COPD and lung cancer.
我们的目的是评估肺气肿评分在预测 COPD 和肺癌死亡中的作用。
对 9047 名男性和女性进行低剂量 CT 扫描，以评估肺气肿的存在，记录其年龄和吸烟史。根据肺气肿的存在情况对每个扫描进行评分，分为无、轻度、中度或重度。随访时间从 CT 扫描时间计算到死亡时间或 2007 年 12 月 31 日，以先到者为准。采用 Cox 回归分析计算肺气肿作为死亡预测指标的风险比（HR）。
中位年龄为 65 岁，4433 名（49%）为男性，4133 名（46%）目前吸烟或在 5 年内戒烟。2637 名（29%）患者存在肺气肿，是 COPD 死亡的显著预测指标（HR，9.3；95%CI，4.3-20.2；P<.0001）和肺癌死亡的显著预测指标（HR，1.7；95%CI，1.1-2.5；P=.013），即使在调整年龄和吸烟史后也是如此。
CT 扫描上肺气肿的视觉评估是 COPD 和肺癌死亡的重要预测指标。
