Identification of frequent acute exacerbations phenotype in COPD patients based on imaging and clinical characteristics - 04/03/23
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Abstract |
Background |
Chronic obstructive pulmonary disease (COPD) is a common disease with high morbidity, with acute exacerbations manifesting as a worsening of respiratory symptoms. This study aimed to identify the frequent acute exacerbation phenotype in patients with COPD based on imaging and clinical characteristics.
Methods |
Patients with COPD (n = 201) were monitored for acute exacerbations one year after their initial hospital admission and further divided into frequent and non-frequent exacerbation groups according to the frequency and severity of acute exacerbations. All patients underwent high resolution CT scans and low attenuation area less than −950Hu (LAA-950) in the whole lung was measured. Differences in visual subtypes, LAA-950, and clinical basic characteristics were compared between groups. The clinical factors influencing frequent exacerbation were determined using binary logistic regression. Finally, based on imaging and clinical factors, the receiver operating characteristic curve was used to identify the phenotype of COPD with frequent acute exacerbations.
Results |
Patients with frequent exacerbations had a larger LAA-950 than those non-frequent exacerbations patients (p<0.001). Frequent acute exacerbations were associated with worsening visual subtypes. Multivariate binary logistic regression illustrated that age, smoking status, BMI, FEV1 pred, and LAA-950 were associated with frequent exacerbations of COPD. The area under the receiver operating characteristic curve for predicting frequent exacerbations based on age, smoking status, BMI, FEV1 pred, and LAA-950 was 0.907 (p<0.001).
Conclusion |
The combination of imaging and clinical characteristics reached high diagnostic efficacy in the identification of frequent acute exacerbations in patients with COPD.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Low attenuation area less than −950Hu (LAA-950) is associated with frequent acute exacerbations of COPD to some extent. |
• | COPD patients with frequent acute exacerbations tended to have more severe visual subtypes phenotype. |
• | Combining imaging with clinical features reached good diagnostic efficacy in predicting frequent acute exacerbations of COPD. |
Keywords : Chronic obstructive pulmonary disease, Acute exacerbation, Pulmonary function test, High-resolution computed tomography, Low attenuation area, Visual subtype
Abbreviations : COPD, AECOPD, FEV1, GOLD, IQR, LAA, PFTs, PSE, FVC, FEV1 pred, RV, TLC
Plan
Vol 209
Article 107150- avril 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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