Multicenter Study

. 2021 Jan:176:106245.

doi: 10.1016/j.rmed.2020.106245. Epub 2020 Nov 20.

Qualitative emphysema and risk of COPD hospitalization in a multicenter CT lung cancer screening cohort study

Lee Gazourian¹, William B Thedinger², Shawn M Regis³, Elizabeth J Pagura⁴, Lori Lyn Price⁵, Melissa Gawlik⁶, Cristina F Stefanescu⁷, Carla Lamb⁴, Kimberly M Rieger-Christ⁸, Harpreet Singh⁹, Marcel Casasola⁹, Alexander R Walker⁹, Arashdeep Rupal⁹, Avignat S Patel⁴, Carolyn E Come⁴, Ava M Sanayei², William P Long², Giulia S Rizzo¹⁰, Andrea B McKee³, George R Washko¹¹, Raul San Jose Estepar¹², Christoph Wald¹³, Brady J McKee¹³, Carey C Thomson¹⁴, Timothy N Liesching⁴

Affiliations

¹ Department of Medicine, Division of Pulmonary and Critical Care Medicine, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA. Electronic address: Lee.Gazourian@lahey.org.
² Tufts University School of Medicine, Boston, MA, 02111, USA.
³ Department of Radiation Oncology, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA.
⁴ Department of Medicine, Division of Pulmonary and Critical Care Medicine, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA.
⁵ Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, 02111, USA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, 02111, USA.
⁶ Quality and Safety, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA.
⁷ Department of Pediatrics, Tufts Medical CenterBoston, MA, 02111, USA.
⁸ Translational Research, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA.
⁹ Department of Medicine, Mount Auburn Hospital, Cambridge, MA, 02138, USA.
¹⁰ Department of General Surgery, UMass Memorial Medical Center, Worcester, MA, 01655, USA.
¹¹ Department of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA; Applied Chest Imaging Laboratories, Brigham and Women's Hospital, Boston, MA, 02115, USA.
¹² Department of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA; Department of Radiology, Brigham and Women's Hospital Boston, MA, 02115, USA.
¹³ Department of Radiology, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA.
¹⁴ Department of Medicine, Mount Auburn Hospital, Cambridge, MA, 02138, USA; Harvard Medical School, Boston, MA, 02115, USA; Division of Pulmonary and Critical Care Medicine, Mount Auburn Hospital, Cambridge, MA, 02138, USA.

PMID: 33253972
PMCID: PMC7890561
DOI: 10.1016/j.rmed.2020.106245

Multicenter Study

Qualitative emphysema and risk of COPD hospitalization in a multicenter CT lung cancer screening cohort study

Lee Gazourian et al. Respir Med. 2021 Jan.

. 2021 Jan:176:106245.

doi: 10.1016/j.rmed.2020.106245. Epub 2020 Nov 20.

Authors

Affiliations

¹ Department of Medicine, Division of Pulmonary and Critical Care Medicine, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA. Electronic address: Lee.Gazourian@lahey.org.
² Tufts University School of Medicine, Boston, MA, 02111, USA.
³ Department of Radiation Oncology, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA.
⁴ Department of Medicine, Division of Pulmonary and Critical Care Medicine, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA.
⁵ Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, 02111, USA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, 02111, USA.
⁶ Quality and Safety, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA.
⁷ Department of Pediatrics, Tufts Medical CenterBoston, MA, 02111, USA.
⁸ Translational Research, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA.
⁹ Department of Medicine, Mount Auburn Hospital, Cambridge, MA, 02138, USA.
¹⁰ Department of General Surgery, UMass Memorial Medical Center, Worcester, MA, 01655, USA.
¹¹ Department of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA; Applied Chest Imaging Laboratories, Brigham and Women's Hospital, Boston, MA, 02115, USA.
¹² Department of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA; Department of Radiology, Brigham and Women's Hospital Boston, MA, 02115, USA.
¹³ Department of Radiology, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA.
¹⁴ Department of Medicine, Mount Auburn Hospital, Cambridge, MA, 02138, USA; Harvard Medical School, Boston, MA, 02115, USA; Division of Pulmonary and Critical Care Medicine, Mount Auburn Hospital, Cambridge, MA, 02138, USA.

PMID: 33253972
PMCID: PMC7890561
DOI: 10.1016/j.rmed.2020.106245

Abstract

Background: In the United States, 9 to 10 million Americans are estimated to be eligible for computed tomographic lung cancer screening (CTLS). Those meeting criteria for CTLS are at high-risk for numerous cardio-pulmonary co-morbidities. The objective of this study was to determine the association between qualitative emphysema identified on screening CTs and risk for hospital admission.

Study design and methods: We conducted a retrospective multicenter study from two CTLS cohorts: Lahey Hospital and Medical Center (LHMC) CTLS program, Burlington, MA and Mount Auburn Hospital (MAH) CTLS program, Cambridge, MA. CTLS exams were qualitatively scored by radiologists at time of screening for presence of emphysema. Multivariable Cox regression models were used to evaluate the association between CT qualitative emphysema and all-cause, COPD-related, and pneumonia-related hospital admission.

Results: We included 4673 participants from the LHMC cohort and 915 from the MAH cohort. 57% and 51.9% of the LHMC and MAH cohorts had presence of CT emphysema, respectively. In the LHMC cohort, the presence of emphysema was associated with all-cause hospital admission (HR 1.15, CI 1.07-1.23; p < 0.001) and COPD-related admission (HR 1.64; 95% CI 1.14-2.36; p = 0.007), but not with pneumonia-related admission (HR 1.52; 95% CI 1.27-1.83; p < 0.001). In the MAH cohort, the presence of emphysema was only associated with COPD-related admission (HR 2.05; 95% CI 1.07-3.95; p = 0.031).

Conclusion: Qualitative CT assessment of emphysema is associated with COPD-related hospital admission in a CTLS population. Identification of emphysema on CLTS exams may provide an opportunity for prevention and early intervention to reduce admission risk.

Keywords: Emphysema; Lung cancer; Lung cancer screening.

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Conflict of interest statement

Declaration of interests

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

**Figure 1:**
Hospital Admission Kaplan-Meier Plot for Qualitative Emphysema

**Figure 2:**
COPD Admission Kaplan-Meir Plot and Emphysema

**Figure 3:**
Pneumonia Admission Kaplan-Meir Plot and Emphysema

See this image and copyright information in PMC

References

1. Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report. GOLD Executive Summary. Am J Respir Crit Care Med. 2017;195(5):557–582. - PubMed
1. Heron M Deaths: Leading Causes for 2016. Natl Vital Stat Rep. 2018;67(6):1–77. - PubMed
1. Halbert RJ, Natoli JL, Gano A, Badamgarav E, Buist AS, Mannino DM. Global burden of COPD: systematic review and meta-analysis. Eur. Respir. J. 2006;28(3):523–532. - PubMed
1. Ford ES, Croft JB, Mannino DM, Wheaton AG, Zhang X, Giles WH. COPD surveillance--United States, 1999–2011. Chest. 2013;144(1):284–305. - PMC - PubMed
1. Ford ES, Murphy LB, Khavjou O, Giles WH, Holt JB, Croft JB. Total and State-Specific Medical and Absenteeism Costs of COPD Among Adults Aged 18 Years in the United States for 2010 and Projections Through 2020. Chest. 2015;147(1):31–45. - PubMed

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Qualitative emphysema and risk of COPD hospitalization in a multicenter CT lung cancer screening cohort study

Affiliations

Qualitative emphysema and risk of COPD hospitalization in a multicenter CT lung cancer screening cohort study

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Research Materials