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Chest CT Indicates Mortality Risk in COPD

WEDNESDAY, April 7, 2021 -- Soft tissue markers on chest computed tomography (CT) indicate the risk for mortality among individuals with chronic obstructive pulmonary disease (COPD), according to a study published online April 6 in Radiology.

Farhad Pishgar, M.D., M.P.H., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues examined correlations between the subcutaneous adipose tissue (SAT), intermuscular adipose tissue (IMAT), and pectoralis muscle (PM) areas from chest CT with mortality in individuals with COPD in a secondary analysis of a prospectively enrolled cohort. Data were included for 2,994 participants, of whom 265 had COPD.

Of those with COPD, 49 participants (18 percent) died during follow-up. The researchers observed moderate-to-excellent reliabilities for the SAT, IMAT, and PM areas (intraclass correlation coefficient, 0.88 to 0.99). The SAT and IMAT indexes were correlated with the fat mass index in the 2,994 participants. Lower mortality risks were seen for those with COPD and a higher SAT index (hazard ratio, 0.2 per doubling), whereas the risk for mortality was higher in association with a higher IMAT index (hazard ratio, 1.4 per doubling).

"These chest CT-derived markers of body composition may have an added predictive value for adverse clinical outcomes such as all-cause mortality in patients with chronic obstructive pulmonary disease," the authors write. "Although we were able to show the associations between soft-tissue markers and mortality in COPD, future studies with larger sample sizes are required to confirm these findings."

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