Journal article
Per cent emphysema is associated with respiratory and lung cancer mortality in the general population: a cohort study
Thorax, Vol.71(7), pp.624-632
07/2016
DOI: 10.1136/thoraxjnl-2015-207822
PMID: 27048196
Abstract
BackgroundEmphysema on CT is a risk factor for all-cause mortality in persons with and without airflow obstruction; however, causes of death associated with emphysema remain uncertain, particularly in the general population.AimsTo test associations between quantitatively assessed emphysema on CT and cause of death in persons with and without a substantial smoking history.MethodsThe Multi-Ethnic Study of Atherosclerosis recruited 6814 participants, aged 45–84 years and without clinical cardiovascular disease, in 2000–2002. Per cent emphysema was defined on cardiac CT as per cent of lung voxels less than −950 Hounsfield units; emphysema on CT was defined as per cent emphysema above the upper limit of normal. Cause of death was classified by administrative codes. Proportional-hazards models were adjusted for age, race/ethnicity, gender, body mass index, smoking status, pack-years, coronary artery calcium, site and education. Additional adjustment for lung function was made in a subset with spirometry from 2004 to 2006.ResultsThere were 1091 deaths over 12 years median follow-up. Emphysema on CT was strongly associated with increased mortality due to respiratory diseases (adjusted HR 2.94, 95% CI 1.68 to 5.15), particularly chronic lower respiratory diseases (adjusted HR 9.54, 95% CI 4.70 to 19.35), and lung cancer (adjusted HR 1.84, 95% CI 1.09 to 3.12), but not cardiovascular disease. Associations persisted among participants with fewer than 10 pack-years and those without physician-diagnosed respiratory disease, and were similar after adjustment for airflow measures and in persons without airflow limitation.ConclusionsQuantitatively assessed emphysema on CT is associated with greater respiratory disease and lung cancer mortality, even among persons without traditional risk factors.
Details
- Title: Subtitle
- Per cent emphysema is associated with respiratory and lung cancer mortality in the general population: a cohort study
- Creators
- Elizabeth C Oelsner - Department of Epidemiology, Mailman School of Public Health at Columbia University, New York, New York, USAJ Jeffrey Carr - Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USAPaul L Enright - Department of Medicine, University of Arizona, Tuscon, Arizona, USAEric A Hoffman - Department of Radiology, University of Iowa, Iowa City, Iowa, USAAaron R Folsom - Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USASteven M Kawut - Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USARichard A Kronmal - Collaborative Health Studies Coordinating Center, University of Washington, Seattle, Washington, USADavid J Lederer - Department of Medicine, Columbia University Medical Center, New York, New York, USAJoao A C Lima - Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USAGina S Lovasi - Department of Epidemiology, Mailman School of Public Health at Columbia University, New York, New York, USABenjamin M Smith - Respiratory Division, McGill University, Montreal, Quebec, CanadaSteven J Shea - Department of Epidemiology, Mailman School of Public Health at Columbia University, New York, New York, USAR Graham Barr - Department of Epidemiology, Mailman School of Public Health at Columbia University, New York, New York, USA
- Resource Type
- Journal article
- Publication Details
- Thorax, Vol.71(7), pp.624-632
- DOI
- 10.1136/thoraxjnl-2015-207822
- PMID
- 27048196
- ISSN
- 0040-6376
- eISSN
- 1468-3296
- Grant note
- DOI: 10.13039/100000050, name: National Heart, Lung, and Blood Institute, award: N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, N01-HC-95169, R01-HL077612, RC1-100543, UL1-TR000040
- Language
- English
- Date published
- 07/2016
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
- Record Identifier
- 9984051776602771
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