title: CT scan findings of emphysema predict mortality in COPD.
abstract: BACKGROUND
  Emphysematous change as assessed by CT imaging has been reported to correlate with COPD prognostic factors such as FEV(1) and diffusing capacity of the lung for carbon monoxide (Dlco). However, few studies have assessed the relationship between CT scan assessment and COPD mortality from mild to severe stages of the disease. In this study, we analyzed this relationship in patients with various stages of COPD.
  
  
  METHODS
  Two hundred and fifty-one outpatients with stable COPD were included in the study. CT scan and pulmonary function tests were performed at study entry in a single institution. The percentage of low attenuation area was measured to quantitatively evaluate emphysematous change with a custom-made software. Prognostic data also were collected, and the median follow-up time was 8 years.
  
  
  RESULTS
  Of the 251 patients, 79 died, with 40 classified as respiratory deaths not involving lung cancer. Univariate Cox analysis revealed that emphysematous change as assessed by CT scan, lung function, age, or BMI were significantly correlated with mortality. Multivariate analysis revealed that emphysematous change as assessed by CT scan had the best association with mortality.
  
  
  CONCLUSIONS
  Emphysematous change as assessed by CT scan predicts respiratory mortality in outpatients with various stages of COPD.
authors.affiliation: Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan.
authors.forename: Akane
authors.initials: A
authors.lastname: Haruna
authors.forename: Shigeo
authors.initials: S
authors.lastname: Muro
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Nakano
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ohara
authors.forename: Yuma
authors.initials: Y
authors.lastname: Hoshino
authors.forename: Emiko
authors.initials: E
authors.lastname: Ogawa
authors.forename: Toyohiro
authors.initials: T
authors.lastname: Hirai
authors.forename: Akio
authors.initials: A
authors.lastname: Niimi
authors.forename: Koichi
authors.initials: K
authors.lastname: Nishimura
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chin
authors.forename: Michiaki
authors.initials: M
authors.lastname: Mishima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality*; D011656:Pulmonary Emphysema / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed