Traction Bronchiectasis/Bronchiolectasis is Associated with Interstitial Lung Abnormality Mortality

Eur J Radiol. 2020 Aug;129:109073. doi: 10.1016/j.ejrad.2020.109073. Epub 2020 May 18.

Abstract

Purpose: To investigate if the presence and severity of traction bronchiectasis/bronchiolectasis are associated with poorer survival in subjects with ILA.

Method: The study included 3,594 subjects (378 subjects with ILA and 3,216 subjects without ILA) in AGES-Reykjavik Study. Chest CT scans of 378 subjects with ILA were evaluated for traction bronchiectasis/bronchiolectasis, defined as dilatation of bronchi/bronchioles within areas demonstrating ILA. Traction bronchiectasis/bronchiolectasis Index (TBI) was assigned as: TBI = 0, ILA without traction bronchiectasis/bronchiolectasis: TBI = 1, ILA with bronchiolectasis but without bronchiectasis or architectural distortion: TBI = 2, ILA with mild to moderate traction bronchiectasis: TBI = 3, ILA and severe traction bronchiectasis and/or honeycombing. Overall survival (OS) was compared among the subjects in different TBI groups and those without ILA.

Results: The median OS was 12.93 years (95%CI; 12.67 - 13.43) in the subjects without ILA; 11.95 years (10.03 - not reached) in TBI-0 group; 8.52 years (7.57 - 9.30) in TBI-1 group; 7.63 years (6.09 - 9.10) in TBI-2 group; 5.40 years (1.85 - 5.98) in TBI-3 group. The multivariable Cox models demonstrated significantly shorter OS of TBI-1, TBI-2, and TBI-3 groups compared to subjects without ILA (P < 0.0001), whereas TBI-0 group had no significant OS difference compared to subjects without ILA, after adjusting for age, sex, and smoking status.

Conclusions: The presence and severity of traction bronchiectasis/bronchiolectasis are associated with shorter survival. The traction bronchiectasis/bronchiolectasis is an important contributor to increased mortality among subjects with ILA.

Keywords: Age Gene/Environment Susceptibility-Reykjavik Study; Interstitial lung abnormality; Pulmonary fibrosis; Traction bronchiectasis; Usual interstitial pneumonia.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bronchiectasis / complications*
  • Bronchiectasis / diagnostic imaging*
  • Cohort Studies
  • Female
  • Humans
  • Iceland / epidemiology
  • Longitudinal Studies
  • Lung / diagnostic imaging
  • Lung Diseases, Interstitial / complications*
  • Lung Diseases, Interstitial / mortality*
  • Male
  • Proportional Hazards Models
  • Severity of Illness Index
  • Survival Analysis
  • Tomography, X-Ray Computed / methods*