Emphysema is a mortality predictor, according to study
According to a study led by researchers from Norway, the severity of emphysema predicts mortality risk. It looks like emphysema, assessed using computed tomography, is an independent predictor of all-cause, cardiovascular, and respiratory mortality in patients with and without chronic obstructive pulmonary disease (COPD).
COPD is a chronic respiratory disease that has two major symptoms: cough and dyspnea. Cough with sputum occurs mainly in those with chronic bronchitis and dyspnea occurs mostly in people who have emphysema. COPD is one of the most common respiratory disease that occurs in old people and one of the major causes of mortality and morbidity. Lead author Ane Johannessen, PhD, a postdoctoral researcher at Haukeland University Hospital in Bergen, Norway, said that this is their first study investigating the link between emphysema severity and mortality risk in a community-based sample. “The relationship between emphysema levels and mortality we found can be used in the risk assessment of these patients,” said Johannessen.
Emphysema, which is part of COPD, means enlargement of the distal airways and alveolar wall rupture. Thus gas exchange cannot perform normally and carbon dioxide is trapped in the lungs. In addition, the lungs lose their elasticity, which disrupts gas exchange again. In this way dyspnea occurs and the patient begins to have difficulty in breathing especially when doing exercise. Emphysema can be assessed using spirometry, which evaluates respiratory function tests, and imaging (computed tomography, etc.). COPD can lead to cardiac complications, that is can cause right heart failure due to pulmonary circulation damage. It should be noted that although it is a disease that can be controlled with drugs (bronchodilators, anticholinergics, corticosteroids), COPD affects a patient’s quality of life significantly.
The study included a sample of 947 ever-smokers with and without COPD who were followed for 8 years. Degree of emphysema was classified into low, medium and high, and the classification was based on the CT scanning. Also, patients were evaluated with the help of spirometry and it was found that of the 947 study participants, 462 had COPD.
After statistical analysis, it was observed that 44% of the 189 who had high degree emphysema died. In contrast, only 4% of the 568 patients with low degrees emphysema died. Moreover, the researchers also found that survival time was 19 months longer in patients with low degrees emphysema compared to those who had medium or high degree emphysema. It was also shown that airway wall thickness is not an independent predictor of mortality, but that increased airway wall thickness reduced life expectancy in patients with severe emphysema.