title: High-resolution computed tomography findings in elderly patients with asthma.
abstract: OBJECTIVE
  Based on the hypothesis that airway remodelling is related to the duration of asthma, HRCT scanning should show greater abnormalities in the early-onset than the late-onset asthmatics. It was, therefore, intended to assess the presence and the frequency of airway and parenchymal abnormalities with high-resolution computed tomography (HRCT) in elderly asthmatic patients, and to determine whether these abnormalities are related to the duration of asthma.
  
  
  METHODS
  Sixty-eight clinically stable asthmatic patients aged > or =60 yr were included in this prospective study. The patients were separated into two groups according to the duration of symptoms as late-onset asthma (n=31) with disease duration of <5 yr, and early-onset asthma (n=37) with disease duration of > or =5 yr. All patients were lifelong non-smoker and had been using inhaled beta agonists and inhaled steroids. HRCT-scanning and histamine inhalation test were performed on all patients.
  
  
  RESULTS
  In comparison with late-onset asthmatic patients, those with early-onset asthma had significantly higher frequency of emphysema (21.6% versus 0.0%, p=0.006), bronchial dilatation (13.9% versus 0.0%, p=0.03) and bronchial wall thickness (41.7% versus 12.9%, p=0.01). Multiple logistic regression analysis identified that early-onset of disease was an independent risk factor for the presence of irreversible HRCT-scan abnormalities in elderly asthmatics [odds ratio (OR): 9.4 (2.7-32.7), p=0.00001].
  
  
  CONCLUSIONS
  Present data suggest that HRCT abnormalities in early-onset elderly asthmatics reflect parenchymal and airway changes that become irreversible throughout the long course of the disease.
authors.affiliation: Department of Radiology, School of Medicine, University of Kirikkale, 71100 Kirikkale, Turkey. dryilmazsevda@yahoo.com
authors.forename: Sevda
authors.initials: S
authors.lastname: Yilmaz
authors.forename: Aydanur
authors.initials: A
authors.lastname: Ekici
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ekici
authors.forename: Hatice
authors.initials: H
authors.lastname: Keles
mesh_terms: D000368:Aged; D001249:Asthma / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D018450:Disease Progression; D004646:Emphysema / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D015898:Tomography Scanners, X-Ray Computed