Journal article
Association Between Interstitial Lung Abnormalities and All-Cause Mortality
JAMA : the journal of the American Medical Association, Vol.315(7), pp.672-681
02/16/2016
DOI: 10.1001/jama.2016.0518
PMCID: PMC4828973
PMID: 26881370
Abstract
Interstitial lung abnormalities have been associated with lower 6-minute walk distance, diffusion capacity for carbon monoxide, and total lung capacity. However, to our knowledge, an association with mortality has not been previously investigated.
To investigate whether interstitial lung abnormalities are associated with increased mortality.
Prospective cohort studies of 2633 participants from the FHS (Framingham Heart Study; computed tomographic [CT] scans obtained September 2008-March 2011), 5320 from the AGES-Reykjavik Study (Age Gene/Environment Susceptibility; recruited January 2002-February 2006), 2068 from the COPDGene Study (Chronic Obstructive Pulmonary Disease; recruited November 2007-April 2010), and 1670 from ECLIPSE (Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints; between December 2005-December 2006).
Interstitial lung abnormality status as determined by chest CT evaluation.
All-cause mortality over an approximate 3- to 9-year median follow-up time. Cause-of-death information was also examined in the AGES-Reykjavik cohort.
Interstitial lung abnormalities were present in 177 (7%) of the 2633 participants from FHS, 378 (7%) of 5320 from AGES-Reykjavik, 156 (8%) of 2068 from COPDGene, and in 157 (9%) of 1670 from ECLIPSE. Over median follow-up times of approximately 3 to 9 years, there were more deaths (and a greater absolute rate of mortality) among participants with interstitial lung abnormalities when compared with those who did not have interstitial lung abnormalities in the following cohorts: 7% vs 1% in FHS (6% difference [95% CI, 2% to 10%]), 56% vs 33% in AGES-Reykjavik (23% difference [95% CI, 18% to 28%]), and 11% vs 5% in ECLIPSE (6% difference [95% CI, 1% to 11%]). After adjustment for covariates, interstitial lung abnormalities were associated with a higher risk of death in the FHS (hazard ratio [HR], 2.7 [95% CI, 1.1 to 6.5]; P = .03), AGES-Reykjavik (HR, 1.3 [95% CI, 1.2 to 1.4]; P < .001), COPDGene (HR, 1.8 [95% CI, 1.1 to 2.8]; P = .01), and ECLIPSE (HR, 1.4 [95% CI, 1.1 to 2.0]; P = .02) cohorts. In the AGES-Reykjavik cohort, the higher rate of mortality could be explained by a higher rate of death due to respiratory disease, specifically pulmonary fibrosis.
In 4 separate research cohorts, interstitial lung abnormalities were associated with a greater risk of all-cause mortality. The clinical implications of this association require further investigation.
Details
- Title: Subtitle
- Association Between Interstitial Lung Abnormalities and All-Cause Mortality
- Creators
- Rachel K Putman - Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MassachusettsHiroto Hatabu - Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts3Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MassachusettsTetsuro Araki - Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MassachusettsGunnar Gudmundsson - Department of Respiratory Medicine and Sleep, Landspital University Hospital, University of Iceland, Reykjavik, IcelandWei Gao - Department of Biostatistics, Boston University School of Public Health, Boston, MassachusettsMizuki Nishino - Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts3Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MassachusettsYuka Okajima - Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts6Department of Radiology, St. Luke's International Hospital, Tokyo, JapanJosée Dupuis - Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts7National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MassachusettsJeanne C Latourelle - Pulmonary Center, Department of Medicine, Boston University, Boston, Massachusetts9Department of Neurology, Boston University, Boston, MassachusettsMichael H Cho - Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts10Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MassachusettsSouheil El-Chemaly - Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MassachusettsHarvey O Coxson - Department of Radiology, University of British Columbia, Vancouver, BC, CanadaBartolome R Celli - Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MassachusettsIsis E Fernandez - Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts12Comprehensive Pneumology Center, Ludwig-Maximilians-University, University Hospital Grosshadern, Munich, Germany13Helmholtz Zentrum MünchenOscar E Zazueta - Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MassachusettsJames C Ross - Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts14Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Boston, MassachusettsRola Harmouche - Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts14Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Boston, MassachusettsRaúl San José Estépar - Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts14Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Boston, MassachusettsAlejandro A Diaz - Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MassachusettsSigurdur Sigurdsson - Icelandic Heart Association, Kopavogur, IcelandElías F Gudmundsson - Icelandic Heart Association, Kopavogur, IcelandGudny Eiríksdottír - Icelandic Heart Association, Kopavogur, IcelandThor Aspelund - Icelandic Heart Association, Kopavogur, Iceland16University of Iceland, Reykjavik, IcelandMatthew J Budoff - Department of Medicine, Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CaliforniaGregory L Kinney - Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Denver, ColoradoJohn E Hokanson - Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Denver, ColoradoMichelle C Williams - University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, Edinburgh, ScotlandJohn T Murchison - Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, ScotlandWilliam MacNee - Centre for Inflammation Research, University of Edinburgh, Edinburgh, ScotlandUdo Hoffmann - Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MassachusettsChristopher J O'Donnell - National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts23Cardiovascular Epidemiology and Human Genomics Branch, NHLBI Division of Intramural Research, Bethesda, MarylandLenore J Launer - Intramural Research Program, National Institute of Aging, NIH, Bethesda, MarylandTamara B Harrris - Intramural Research Program, National Institute of Aging, NIH, Bethesda, MarylandVilmundur Gudnason - Icelandic Heart Association, Kopavogur, Iceland16University of Iceland, Reykjavik, IcelandEdwin K Silverman - Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts10Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MassachusettsGeorge T O'Connor - National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts8Pulmonary Center, Department of Medicine, Boston University, Boston, MassachusettsGeorge R Washko - Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts3Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MassachusettsIvan O Rosas - Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MassachusettsGary M Hunninghake - Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts3Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MassachusettsEvaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE)COPDGene Investigators
- Contributors
- Eric A Hoffman (Contributor) - University of Iowa, Radiology
- Resource Type
- Journal article
- Publication Details
- JAMA : the journal of the American Medical Association, Vol.315(7), pp.672-681
- Publisher
- United States
- DOI
- 10.1001/jama.2016.0518
- PMID
- 26881370
- PMCID
- PMC4828973
- ISSN
- 0098-7484
- eISSN
- 1538-3598
- Grant note
- T32 HL007633 / NHLBI NIH HHS 1K23CA157631 / NCI NIH HHS K01 HL118714 / NHLBI NIH HHS R01 HL116931 / NHLBI NIH HHS N01-AG-1-2100 / NIA NIH HHS 27120120022C / PHS HHS R01 HL113264 / NHLBI NIH HHS K23 CA157631 / NCI NIH HHS N01-HC-25195 / NHLBI NIH HHS Intramural NIH HHS R21 HL119902 / NHLBI NIH HHS R01 HL130974 / NHLBI NIH HHS K25 HL104085 / NHLBI NIH HHS U01 HL089897 / NHLBI NIH HHS R01 HL107246 / NHLBI NIH HHS R01 HL089856 / NHLBI NIH HHS P01 HL114501 / NHLBI NIH HHS HHSN27120120022C / PHS HHS R01 HL122464 / NHLBI NIH HHS N01HC25195 / NHLBI NIH HHS P01 HL105339 / NHLBI NIH HHS S10 OD018526 / NIH HHS K08 HL097029 / NHLBI NIH HHS R01 HL111024 / NHLBI NIH HHS R01 HL089897 / NHLBI NIH HHS R01 HL116473 / NHLBI NIH HHS
- Language
- English
- Date published
- 02/16/2016
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Psychiatry; Internal Medicine
- Record Identifier
- 9984051540902771
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