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J Korean Med Sci.  2011 Dec;26(12):1606-1612. 10.3346/jkms.2011.26.12.1606.

Comparison of Clinico-Physiologic and CT Imaging Risk Factors for COPD Exacerbation

Affiliations
  • 1Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ymoh55@amc.seoul.kr
  • 2Department of Radiology, and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 3Department of Pulmonary and Critical Care Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
  • 4Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
  • 5Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 6Division of Pulmonology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
  • 7Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon, Korea.
  • 8Department of Internal Medicine, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul, Korea.
  • 9Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Clinical Research Institute, Seoul National University Hospital, Lung Institute, Medical Research Center, Seoul National Univ
  • 10Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Korea University Anam Hospital, Seoul, Korea.
  • 11Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 12Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
  • 13Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 14Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Korea.

Abstract

To date, clinico-physiologic indices have not been compared with quantitative CT imaging indices in determining the risk of chronic obstructive pulmonary disease (COPD) exacerbation. We therefore compared clinico-physiologic and CT imaging indices as risk factors for COPD exacerbation in patients with COPD. We retrospectively analyzed 260 COPD patients from pulmonary clinics at 11 hospitals in Korea from June 2005 to November 2009 and followed-up for at least one year. At the time of enrollment, none of these patients had COPD exacerbations for at least 2 months. All underwent clinico-physiologic and radiological evaluation for risk factors of COPD exacerbation. After 1 yr, 106 of the 260 patients had at least one exacerbation of COPD. Multiple logistic regression analysis showed that old age, high Charlson Index, and low FEV1 were significant in a clinico-physiologic model, with C-statistics of 0.69, and that increased age and emphysema index were significant in a radiologic model, with C-statistics of 0.64. The difference between the two models was statistically significant (P = 0.04 by bootstrap analysis). Combinations of clinico-physiologic risk factors may be better than those of imaging risk factors in predicting COPD exacerbation.

Keyword

Pulmonary Disease, Chronic Obstructive; Exacerbation; Risk Factors; Computed Tomography

MeSH Terms

Aged
Aged, 80 and over
Disease Progression
Female
Humans
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive/*diagnosis/pathology/*physiopathology
Retrospective Studies
Risk Factors
Severity of Illness Index
*Tomography, X-Ray Computed

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