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- Title
Suspected Interstitial Lung Disease in COPDGene Study.
- Authors
Rose, Jonathan A.; Menon, Aravind A.; Takuya Hino; Akinori Hata; Mizuki Nishino; Lynch, David A.; Rosas, Ivan O.; El-Chemaly, Souheil; Raby, Benjamin A.; Ash, Samuel Y.; Bina Choi; Washko, George R.; Silverman, Edwin K.; Cho, Michael H.; Hatabu, Hiroto; Putman, Rachel K.; Hunninghake, Gary M.
- Abstract
Rationale: Although interstitial lung abnormalities (ILA), specific patterns of incidentally-detected abnormal density on computed tomography, have been associated with abnormal lung function and increased mortality, it is unclear if a subset with incidental interstitial lung disease (ILD) accounts for these adverse consequences. Objectives: To define the prevalence and risk factors of suspected ILD and assess outcomes. Methods: Suspected ILD was evaluated in the COPDGene (Chronic Obstructive Pulmonary Disease Genetic Epidemiology) study, defined as ILA and at least one additional criterion: definite fibrosis on computed tomography, FVC less than 80% predicted, or DLCO less than 70% predicted. Multivariable linear, longitudinal, and Cox proportional hazards regression models were used to assess associations with St. George's Respiratory Questionnaire, 6-minute-walk test, supplemental oxygen use, respiratory exacerbations, and mortality. Measurements and Main Results: Of 4,361 participants with available data, 239 (5%) had evidence for suspected ILD, whereas 204 (5%) had ILA without suspected ILD. In multivariable analyses, suspected ILD was associated with increased St. George's Respiratory Questionnaire score (mean difference [MD], 3.9 points; 95% confidence interval [CI], 0.6-7.1; P = 0.02), reduced 6-minute-walk test (MD, 235 m; 95% CI, 256 m to 213 m; P = 0.002), greater supplemental oxygen use (odds ratio [OR], 2.3; 95% CI, 1.1-5.1; P = 0.03) and severe respiratory exacerbations (OR, 2.9; 95% CI, 1.1-7.5; P= 0.03), and higher mortality (hazard ratio, 2.4; 95% CI, 1.2-4.6; P = 0.01) compared with ILA without suspected ILD. Risk factors associated with suspected ILD included selfidentified Black race (OR, 2.0; 95% CI, 1.1-3.3; P = 0.01) and pack-years smoking history (OR, 1.2; 95% CI, 1.1-1.3; P = 0.0005). Conclusions: Suspected ILD is present in half of those with ILA in COPDGene and is associated with exercise decrements and increased symptoms, supplemental oxygen use, severe respiratory exacerbations, and mortality.
- Subjects
INTERNATIONAL Longshoremen's Association; INTERSTITIAL lung diseases; CHRONIC obstructive pulmonary disease; PROPORTIONAL hazards models; OXYGEN therapy; RACE; COMPUTED tomography
- Publication
American Journal of Respiratory & Critical Care Medicine, 2023, Vol 207, Issue 1, p60
- ISSN
1073-449X
- Publication type
Article
- DOI
10.1164/rccm.202203-0550OC