Stephan Jeremy T, Mehta Prakriti, Zepeda David L, Uppal Mohit, Basu Sanjib, Liptay Michael J, Borgia Jeffrey A, Geissen Nicole, Shah Palmi, Karush Justin, Alex Gillian, Seder Christopher W
Rush Medical College, Chicago, Illinois.
Department of Epidemiology and Biostatistics, University of Illinois Chicago, Chicago, Illinois.
Ann Thorac Surg Short Rep. 2023 Jul 15;1(4):558-561. doi: 10.1016/j.atssr.2023.06.011. eCollection 2023 Dec.
The objective of this study was to investigate whether lung cancer screening low-dose computed tomography (LDCT) can be used to identify features associated with increased risk of hospitalization during the subsequent year.
Patients who underwent lung cancer screening between 2015 and 2020 with at least 1-year follow-up were identified. Patient charts were examined and LDCT scans were analyzed using body segmentation software to identify characteristics potentially associated with frailty and injury. Hospitalization was defined as an admission >48 hours within 1 year of the LDCT scan; admissions for elective procedures were excluded.
There were 1606 LDCT scans that met inclusion criteria. The cohort median age was 65 years (interquartile range, 61-70 years), with 54% (875/1606) female, 50% (804/1606) current smokers, and median smoking history of 40 pack-years (interquartile range, 34-50 pack-years). There were 107 hospitalizations within 1 year of the LDCT scan. On univariate analysis, cardiomegaly (odds ratio [OR], 2.83; 95% CI, 1.33-6.04; < .01), emphysema (OR, 1.67; 95% CI, 1.09-2.56; = .02), pulmonary artery enlargement (OR, 2.72; 95% CI, 1.09-6.62; .03), and coronary artery calcification (OR, 1.59; 95% CI, 1.07-2.41; = .02) were associated with increased risk of hospitalization. On multivariate analysis, after controlling for age and sex, cardiomegaly (OR, 2.41; 95% CI, 1.05-4.97; = .03), emphysema (OR, 1.88; 95% CI, 1.19-2.93; < .01), and body mass index >30 kg/m (OR, 1.55; 95% CI, 1.02-2.36; = .04) were associated with increased risk of hospitalization.
In lung cancer screening patients, features extractable from LDCT scans are associated with increased risk of hospitalizations during the subsequent year.
本研究的目的是调查肺癌筛查低剂量计算机断层扫描（LDCT）是否可用于识别与随后一年住院风险增加相关的特征。
确定2015年至2020年间接受肺癌筛查且随访至少1年的患者。检查患者病历，并使用身体分割软件分析LDCT扫描，以识别可能与虚弱和损伤相关的特征。住院定义为LDCT扫描后1年内住院时间超过48小时；择期手术的入院情况被排除。
有1606次LDCT扫描符合纳入标准。队列中位年龄为65岁（四分位间距，61 - 70岁），女性占54%（875/1606），当前吸烟者占50%（804/1606），中位吸烟史为40包年（四分位间距，34 - 50包年）。在LDCT扫描后1年内有107次住院。单因素分析显示，心脏扩大（比值比[OR]，2.83；95%置信区间，1.33 - 6.04；P <.01）、肺气肿（OR，1.67；95%置信区间，1.09 - 2.56；P =.02）、肺动脉增粗（OR，2.72；95%置信区间，1.09 - 6.62；P =.03）和冠状动脉钙化（OR，1.59；95%置信区间，1.07 - 2.41；P =.02）与住院风险增加相关。多因素分析显示，在控制年龄和性别后，心脏扩大（OR，2.41；95%置信区间，1.05 - 4.97；P =.03）、肺气肿（OR，1.88；95%置信区间，1.19 - 2.93；P <.01）和体重指数>30 kg/m²（OR，1.55；95%置信区间，1.02 - 2.36；P =.04）与住院风险增加相关。
在肺癌筛查患者中，从LDCT扫描中提取的特征与随后一年住院风险增加相关。
