• Akane Haruna, Shigeo Muro, Yasutaka Nakano, Tadashi Ohara, Yuma Hoshino, Emiko Ogawa, Toyohiro Hirai, Akio Niimi, Koichi Nishimura, Kazuo Chin, and Michiaki Mishima.
• Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan.
• Chest. 2010 Sep 1;138(3):635-40.

BackgroundEmphysematous 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.MethodsTwo 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.ResultsOf 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.ConclusionsEmphysematous change as assessed by CT scan predicts respiratory mortality in outpatients with various stages of COPD.

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