• Javier J Zulueta, Juan P Wisnivesky, Claudia I Henschke, Rowena Yip, Ali O Farooqi, Dorothy I McCauley, Mildred Chen, Daniel M Libby, James P Smith, Mark W Pasmantier, and David F Yankelevitz.
• Department of Pulmonary Medicine, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain.
• Chest. 2012 May 1;141(5):1216-23.

ObjectiveOur objective was to assess the usefulness of emphysema scores in predicting death from COPD and lung cancer.MethodsEmphysema 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.ResultsMedian 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.ConclusionsVisual assessment of emphysema on CT scan is a significant predictor of death from COPD and lung cancer.

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