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. 2016 Apr 4;3(2):570-579.
doi: 10.15326/jcopdf.3.2.2015.0158.

Hiatal Hernia on Chest High-Resolution Computed Tomography and Exacerbation Rates in COPD Individuals

Cynthia Kim  1   2 , Wei Ouyang  3   2 , Chandra Dass  3 , Huaqing Zhao  4 , Gerard J Criner
Affiliations

Hiatal Hernia on Chest High-Resolution Computed Tomography and Exacerbation Rates in COPD Individuals

Cynthia Kim et al. Chronic Obstr Pulm Dis. .

Abstract

Background: Gastroesophageal reflux disease (GERD) is associated with frequent chronic obstructive pulmonary disease (COPD) exacerbations. Hiatal hernia (HH) contributes to GERD pathogenesis and is identifiable on chest high-resolution computed tomography (HRCT). We hypothesize that the presence of an HH on HRCT identifies those at increased risk for acute exacerbation of COPD. Methods: We retrospectively reviewed a prospectively enrolled cohort of smokers with and without airflow obstruction. HHs were identified visually on inspiratory HRCT. Individuals' demographic and clinical information was compared with secondary analysis performed using a propensity score generated matched cohort. Results: There were 523 COPD individuals and 607 unobstructed smokers. COPD individuals had more HHs than unobstructed smokers, (11.6% versus 6.1%, p < 0.001). COPD individuals with hernias were older, female, overweight and GERD positive as compared to those without hernia. There was no difference in self-reported exacerbation rates or hospitalizations per year, but similar severity of obstruction, smoking rates and long-term oxygen use. Analysis with the matched cohort revealed no significant difference in exacerbation rates. Conclusions: Presence of HHs on inspiratory HRCT scan did not predict worse symptoms or exacerbation rate in COPD individuals. Those with HHs were older, more obese, and predominantly female compared to those without HHs.

Keywords: COPD exacerbation; gastroesophageal reflux disease; hiatal hernia.

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Conflict of interest statement

None of the authors of this paper have any real or apparent conflicts of interest to disclose, nor have any financial or consulting relationships to report. The entire manuscript is the original work of the authors and there was no additional input from any agency or freelance writer.

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