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Title: High-Attenuation Areas on Chest Computed Tomography and Clinical Respiratory Outcomes in Community-Dwelling Adults.

Authors: Podolanczuk, Anna J; Oelsner, Elizabeth C; Barr, R Graham; Bernstein, Elana J; Hoffman, Eric A; Easthausen, Imaani J; Stukovsky, Karen Hinckley; RoyChoudhury, Arindam; Michos, Erin D; Raghu, Ganesh; Kawut, Steven M; Lederer, David J

Published In Am J Respir Crit Care Med, (2017 Dec 01)

Abstract: Areas of increased lung attenuation visualized by computed tomography are associated with all-cause mortality in the general population. It is uncertain whether this association is attributable to interstitial lung disease (ILD).To determine whether high-attenuation areas are associated with the risk of ILD hospitalization and mortality in the general population.We performed a cohort study of 6,808 adults aged 45-84 years sampled from six communities in the United States. High-attenuation areas were defined as the percentage of imaged lung volume with attenuation values between -600 and -250 Hounsfield units. An adjudication panel determined ILD hospitalization and death.After adjudication, 52 participants had a diagnosis of ILD during 75,232 person-years (median, 12.2 yr) of follow-up. There were 48 hospitalizations attributable to ILD (crude rate, 6.4 per 10,000 person-years). Twenty participants died as a result of ILD (crude rate, 2.7 per 10,000 person-years). High-attenuation areas were associated with an increased rate of ILD hospitalization (adjusted hazard ratio, 2.6 per 1-SD increment in high-attenuation areas; 95% confidence interval, 1.9-3.5; P < 0.001), a finding that was stronger among men, African Americans, and Hispanics. High-attenuation areas were also associated with an increased rate of ILD-specific death (adjusted hazard ratio, 2.3; 95% confidence interval, 1.7-3.0; P < 0.001). Our findings were consistent among both smokers and nonsmokers.Areas of increased lung attenuation are a novel risk factor for ILD hospitalization and mortality. Measurement of high-attenuation areas by screening and diagnostic computed tomography may be warranted in at-risk adults.

PubMed ID: 28613921 Exiting the NIEHS site

MeSH Terms: Aged; Aged, 80 and over; Cohort Studies; Female; Humans; Lung Diseases, Interstitial/diagnostic imaging*; Lung Diseases, Interstitial/physiopathology; Lung/diagnostic imaging; Lung/physiopathology; Male; Middle Aged; Tomography, X-Ray Computed/methods*

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