Yang Yingjian, Li Wei, Guo Yingwei, Liu Yang, Li Qiang, Yang Kai, Wang Shicong, Zeng Nanrong, Duan Wenxin, Chen Ziran, Chen Huai, Li Xian, Zhao Wei, Chen Rongchang, Kang Yan
College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China.
Medical Device Innovation Center, Shenzhen Technology University, Shenzhen, China.
Front Med (Lausanne). 2022 Apr 21;9:845286. doi: 10.3389/fmed.2022.845286. eCollection 2022.
Chronic obstructive pulmonary disease (COPD), a preventable lung disease, has the highest prevalence in the elderly and deserves special consideration regarding earlier warnings in this fragile population. The impact of age on COPD is well known, but the COPD risk of the aging process in the lungs remains unclear. Therefore, it is necessary to understand the COPD risk of the aging process in the lungs, providing an early COPD risk decision for adults.
COPD risk is evaluated for adults to make an early COPD risk decision from the perspective of lung radiomics features. First, the subjects are divided into four groups according to the COPD stages. Their ages are divided into eight equal age intervals in each group. Second, four survival Cox models are established based on the lung radiomics features to evaluate the risk probability from COPD stage 0 to suffering COPD and COPD stages. Finally, four risk ranks are defined by equally dividing the COPD risk probability from 0 to 1. Subsequently, the COPD risk at different stages is evaluated with varying age intervals to provide an early COPD risk decision.
The evaluation metrics area under the curve (AUC)/C index of four survival Cox models are 0.87/0.94, 0.84/0.83, 0.94/0.89, and 0.97/0.86, respectively, showing the effectiveness of the models. The risk rank levels up every 5 years for the subjects who had suffered COPD after 60. For the subjects with COPD stage 0, the risk rank of suffering COPD stage I levels up every 5 years after the age of 65 years, and the risk rank of suffering COPD stages II and III & IV levels up every 5 years after the age of 70 years.
Once the age is above 60 years, the patients with COPD need to take action to prevent the progress and deterioration of COPD. Once the age is above 65 years, the patients with COPD stage 0 need to take precautions against COPD.
慢性阻塞性肺疾病（COPD）是一种可预防的肺部疾病，在老年人中患病率最高，在这一脆弱人群中进行早期预警值得特别关注。年龄对COPD的影响是众所周知的，但肺部衰老过程中的COPD风险仍不清楚。因此，有必要了解肺部衰老过程中的COPD风险，为成年人提供早期COPD风险决策。
从肺部影像组学特征的角度评估成年人的COPD风险，以做出早期COPD风险决策。首先，根据COPD阶段将受试者分为四组。每组将他们的年龄分为八个相等的年龄区间。其次，基于肺部影像组学特征建立四个生存Cox模型，以评估从COPD 0期到患COPD及COPD各阶段的风险概率。最后，将COPD风险概率从0到1平均分为四等份来定义四个风险等级。随后，以不同的年龄区间评估不同阶段的COPD风险，以提供早期COPD风险决策。
四个生存Cox模型的评估指标曲线下面积（AUC）/C指数分别为0.87/0.94、0.84/0.83、0.94/0.89和0.97/0.86，表明模型有效。60岁以后患COPD的受试者，风险等级每5年上升一级。对于COPD 0期的受试者，65岁以后患COPD I期的风险等级每5年上升一级，70岁以后患COPD II期和III & IV期的风险等级每5年上升一级。
一旦年龄超过60岁，COPD患者需要采取行动预防COPD的进展和恶化。一旦年龄超过65岁，COPD 0期患者需要预防COPD。
