期刊
PLOS ONE
卷 9, 期 4, 页码 -出版社
PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pone.0093221
关键词
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资金
- National Institutes of Health [R01-HL075476, R01-HL077612, R01-HL093081, RR024156, ES09089]
- City of New York Department of Health and Mental Hygiene
- Starr Foundation
- Empire Blue Cross and Blue Shield
- New York Community Trust
- New York State Office of Science, Technology, and Academic Research
- Rogers Family Fund
- Weill Medical College of Cornell University
- Cornell University
- AMDeC Foundation
- Chest Heart and Stroke Scotland [ResFell07/A109] Funding Source: researchfish
Background: Emphysema on CT is common in older smokers. We hypothesised that emphysema on CT predicts acute episodes of care for chronic lower respiratory disease among older smokers. Materials and Methods: Participants in a lung cancer screening study age >= 60 years were recruited into a prospective cohort study in 2001-02. Two radiologists independently visually assessed the severity of emphysema as absent, mild, moderate or severe. Percent emphysema was defined as the proportion of voxels <= -910 Hounsfield Units. Participants completed a median of 5 visits over a median of 6 years of follow-up. The primary outcome was hospitalization, emergency room or urgent office visit for chronic lower respiratory disease. Spirometry was performed following ATS/ERS guidelines. Airflow obstruction was defined as FEV1/FVC ratio <0.70 and FEV <80% predicted. Results: Of 521 participants, 4% had moderate or severe emphysema, which was associated with acute episodes of care (rate ratio 1.89; 95% CI: 1.01- 3.52) adjusting for age, sex and race/ ethnicity, as was percent emphysema, with similar associations for hospitalisation. Emphysema on visual assessment also predicted incident airflow obstruction ( HR 5.14; 95% CI 2.19- 21.1). Conclusion: Visually assessed emphysema and percent emphysema on CT predicted acute episodes of care for chronic lower respiratory disease, with the former predicting incident airflow obstruction among older smokers.
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