Emphysema scores predict death from COPD and lung cancer

Chest. 2012 May;141(5):1216-1223. doi: 10.1378/chest.11-0101. Epub 2011 Oct 20.


Objective: Our objective was to assess the usefulness of emphysema scores in predicting death from COPD and lung cancer.

Methods: Emphysema was assessed with low-dose CT scans performed on 9,047 men and women for whom age and smoking history were documented. Each scan was scored according to the presence of emphysema as follows: none, mild, moderate, or marked. Follow-up time was calculated from time of CT scan to time of death or December 31, 2007, whichever came first. Cox regression analysis was used to calculate the hazard ratio (HR) of emphysema as a predictor of death.

Results: Median age was 65 years, 4,433 (49%) were men, and 4,133 (46%) were currently smoking or had quit within 5 years. Emphysema was identified in 2,637 (29%) and was a significant predictor of death from COPD (HR, 9.3; 95% CI, 4.3-20.2; P < .0001) and from lung cancer (HR, 1.7; 95% CI, 1.1-2.5; P = .013), even when adjusted for age and smoking history.

Conclusions: Visual assessment of emphysema on CT scan is a significant predictor of death from COPD and lung cancer.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cause of Death
  • Female
  • Follow-Up Studies
  • Humans
  • Image Interpretation, Computer-Assisted*
  • Kaplan-Meier Estimate
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / mortality*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Pulmonary Disease, Chronic Obstructive / diagnostic imaging*
  • Pulmonary Disease, Chronic Obstructive / mortality*
  • Pulmonary Emphysema / diagnostic imaging*
  • Pulmonary Emphysema / mortality*
  • Smoking / adverse effects
  • Tomography, X-Ray Computed*