scholarly journals An Evaluation of quantitative body composition on thoracic computed tomography and the effect on clinical severity in patients with chronic obstructive pulmonary disease

2021 ◽  
Vol 1 (2) ◽  
pp. 75-81
Author(s):  
Furkan Kaya ◽  
Esra Ozgul ◽  
Aydin Balci ◽  
Erhan Bozkurt ◽  
Emre Atay
Keyword(s):  
Computed Tomography ◽  
Body Composition ◽  
Pectoral Muscle ◽  
Clinical Severity ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Thoracic Computed Tomography ◽  
Significant Difference ◽  
Gold Classification ◽  
Severe Copd

The aim of this study was to evaluate the effect on disease severity of the quantitative measurements of pectoral muscle area (PMA), pectoral muscle index (PMI), pectoral muscle density (PMD), subcutaneous adipose tissue (SAT) and mediastinal adipose tissue (MAT) taken on thoracic computed tomography (CT) of patients with chronic obstructive pulmonary disease (COPD), according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification. A retrospective screening was made of patients diagnosed with COPD and applied with thoracic CT and respiratory function tests. For patients with obstructive findings, a record was made of height, weight, body mass index, and smoking history (packet/year). On thoracic axial CT images, the PMA, PMI, PMD, SAT, and MAT values at the aortic arch level were calculated quantitatively using OsiriX software (Pixmeo, Switzerland). The patients were grouped as A-B-C-D according to the GOLD 2018 guidelines. Then two groups were formed as mild-moderate COPD (GOLD A-B) and severe COPD (GOLD C-D). The relationship was evaluated between clinical severity and quantitative body composition values according to the GOLD classification. A total of 80 patients diagnosed with COPD were included in the study comprising 61 males and 19 females. The GOLD A-B group included 43 (53.75%) patients and the GOLD C-D group, 37 (46.25%) patients. No significant difference was determined between the two groups in respect of the PMA, PMI, and PMD values (p=0.001). A statistically significant difference was determined between the groups in respect of the SAT and MAT values (p=0.001, p=0.002, respectively). A cutoff value of <30.04 in PMD (0.964; 95%CI:0.928-1) showed the best performance in predicting the mild-moderate COPD patients (GOLD A-B) with 92% sensitivity and 93% specificity. The results of this study demonstrated that PMD showed the best quantitative body composition performance in the differentiation of mild-moderate and severe COPD disease.

scholarly journals Plasma Fibrinogen Level in Chronic Obstructive Pulmonary Disease and Its Correlation with GOLD Severity Staging

2021 ◽  
Vol 43 (1) ◽  
pp. 1-4
Author(s):  
Achyut Gyawali ◽  
Niraj Bam ◽  
Pankaj Pant ◽  
Santa K Das
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Fibrinogen Level ◽  
Airflow Obstruction ◽  
Plasma Fibrinogen ◽  
Chronic Obstructive ◽  
Plasma Fibrinogen Level ◽  
Obstructive Pulmonary Disease ◽  
Significant Difference ◽  
Severe Copd

Introduction Chronic obstructive pulmonary disease (COPD) has great implications on global health accounting for significant morbidity and mortality. It is a state of chronic inflammation of airways. The aim of this study was to measure the plasma fibrinogen level in patient with COPD and find the relationship between plasma fibrinogen levels and severity of airflow obstruction. MethodsThis observational study was conducted from September 2017 to October 2018, where 80 eligible patients with the diagnosis of acute exacerbation of COPD (AECOPD) were included in the study and their plasma fibrinogen level was measured at the time of discharge. Clinical information was obtained and pulmonary function test (PFT) was done. ResultA total of 80 patients were enrolled. The mean age of the patient was 67.87±11.60 years. Plasma fibrinogen level was 159±12.72 mg/dl in mild COPD, 273.52±62.34 mg/dl in moderate COPD, 312.30±103.67 mg/dl in severe COPD, and 487±102.76 mg/dl in very severe COPD. The comparison between groups showed significant difference in plasma fibrinogen level (p<0.001). There was significant negative correlation between plasma fibrinogen level and forced expiratory volume in one second (FEV1%) predicted (r=-0.71, p=0.01). ConclusionHigh plasma fibrinogen level on discharge was found in COPD patients with severe airflow obstruction, frequent exacerbations and severe level of dyspnoea during AECOPD.

Pulmonary complications and survival after elective infrarenal endovascular abdominal aneurysm repair in patients with documented chronic obstructive pulmonary disease

Vascular ◽  
2020 ◽  
Vol 28 (5) ◽  
pp. 557-567
Author(s):  
Fieke K Oussoren ◽  
Suzanne Holewijn ◽  
Niels Claessens ◽  
Daphne van der Veen ◽  
Michel MPJ Reijnen
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Adverse Events ◽  
Pulmonary Disease ◽  
Morbidity And Mortality ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Co Morbidity ◽  
Risk Of Rupture ◽  
Significant Difference ◽  
Gold Classification

Background Elective abdominal aortic aneurysm (AAA) repair is advocated in patients where risk of rupture exceeds the risks of peri-procedural morbidity and mortality. Chronic obstructive pulmonary disease (COPD) is a known risk factor for AAA and increased operative morbidity in general. Since literature on the correlation between the clinical classification of COPD and morbidity following endovascular infrarenal AAA repair (EVAR) is scarce, assessment per individual remains a challenge. Objective To analyse the pulmonary and all-cause morbidity and mortality in patients with documented COPD and relate this to their GOLD classification. Methods Sixty-eight patients with COPD, documented by a lung function test, who underwent elective EVAR between July 2002 and July 2018 were retrospectively reviewed. The primary endpoint was the incidence of 30-day pulmonary adverse events. Procedural characteristics, length of hospital stay, pulmonary and all-cause morbidity including major adverse events (MAEs) during follow-up and five-year survival divided per GOLD classification were the secondary endpoints. Results There was no statistically significant difference in the incidence of pulmonary adverse events between GOLD I/II and GOLD III/IV patients. There was neither procedural nor 30-day mortality in either group. Through 30 days and 1 year, there was no difference in pulmonary and all-cause morbidity between groups. Three MAEs occurred in the GOLD I/II group versus 2 MAE in the GOLD III/IV group during the first postoperative year. The five-year survival was 66.0%, 60.9% and 61.9% for patients with GOLD I, GOLD II and GOLD III, respectively. Three of four GOLD IV died within the first year after EVAR. Conclusion EVAR can be safely performed in patients with COPD, with low 30-day morbidity and mortality rates. Although severe co-morbidity should be taken into account, EVAR seems to be justified in patients with COPD with a GOLD classification I, II or III. Further research should focus on optimising the pulmonary condition in patients selected for EVAR.

scholarly journals Automatic airway segmentation from computed tomography using robust and efficient 3-D convolutional neural networks

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Antonio Garcia-Uceda ◽  
Raghavendra Selvan ◽  
Zaigham Saghir ◽  
Harm A. W. M. Tiddens ◽  
Marleen de Bruijne
Keyword(s):  
Computed Tomography ◽  
Lung Cancer Screening ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Sensitivity Score ◽  
Thoracic Computed Tomography ◽  
Cancer Screening Trial ◽  
Airway Segmentation ◽  
Pass Through ◽  
Different Characteristics

AbstractThis paper presents a fully automatic and end-to-end optimised airway segmentation method for thoracic computed tomography, based on the U-Net architecture. We use a simple and low-memory 3D U-Net as backbone, which allows the method to process large 3D image patches, often comprising full lungs, in a single pass through the network. This makes the method simple, robust and efficient. We validated the proposed method on three datasets with very different characteristics and various airway abnormalities: (1) a dataset of pediatric patients including subjects with cystic fibrosis, (2) a subset of the Danish Lung Cancer Screening Trial, including subjects with chronic obstructive pulmonary disease, and (3) the EXACT’09 public dataset. We compared our method with other state-of-the-art airway segmentation methods, including relevant learning-based methods in the literature evaluated on the EXACT’09 data. We show that our method can extract highly complete airway trees with few false positive errors, on scans from both healthy and diseased subjects, and also that the method generalizes well across different datasets. On the EXACT’09 test set, our method achieved the second highest sensitivity score among all methods that reported good specificity.

scholarly journals COPD-Lower Respiratory Tract Infection Visual Analogue Score (c-LRTI-VAS) validation in stable and exacerbated patients with COPD

2021 ◽  
Vol 8 (1) ◽  
pp. e000761
Author(s):  
Hendrik Johannes Prins ◽  
Ruud Duijkers ◽  
Johannes M A Daniels ◽  
Thys van der Molen ◽  
Tjip S van der Werf ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Visual Analogue Score ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Significant Difference ◽  
Related Quality

BackgroundWe developed the chronic obstructive pulmonary disease (COPD)-Lower Respiratory Tract Infection-Visual Analogue Score (c-LRTI-VAS) in order to easily quantify symptoms during exacerbations in patients with COPD. This study aimed to validate this score.MethodsIn our study, patients with stable COPD as well as those with an acute exacerbations of COPD (AECOPD) were included. The results of c-LRTI-VAS were compared with other markers of disease activity (lung function parameters, oxygen saturation and two health related quality of life questionnaires (St Georges Respiratory Questionnaire (SGRQ) and Clinical COPD Questionnaire (CCQ)) and validity, reliability and responsiveness were assessed.ResultsEighty-eight patients with clinically stable COPD and 102 patients who had an AECOPD completed the c-LRTI-VAS questionnaire. When testing on two separate occasions for repeatability, no statistically significant difference between total scores was found 0.143 (SD 5.42) (p=0.826). Internal consistency was high across items (Cronbach’s apha 0.755). Correlation with SGRQ and CCQ total scores was moderate to high. After treatment for hospitalised AECOPD, the mean c-LRTI-VAS total score improved 8.14 points (SD 9.13; p≤0.001).Conclusionsc-LRTI-VAS showed proper validity, responsiveness to change and moderate to high correlation with other questionnaires. It, therefore, appears a reliable tool for symptom measurement during AECOPD.Trial registration numberNCT01232140.

scholarly journals Present and future utility of computed tomography scanning in the assessment and management of COPD

2016 ◽  
Vol 48 (1) ◽  
pp. 216-228 ◽  
Author(s):  
Kristoffer Ostridge ◽  
Tom M.A. Wilkinson
Keyword(s):  
Computed Tomography ◽  
Clinical Applications ◽  
Wall Thickening ◽  
Chronic Obstructive ◽  
Clinical Tool ◽  
Obstructive Pulmonary Disease ◽  
Lung Structure ◽  
Computed Tomography Scanning ◽  
Underlying Mechanisms ◽  
Future Utility

Computed tomography (CT) is the modality of choice for imaging the thorax and lung structure. In chronic obstructive pulmonary disease (COPD), it used to recognise the key morphological features of emphysema, bronchial wall thickening and gas trapping. Despite this, its place in the investigation and management of COPD is yet to be determined, and it is not routinely recommended. However, lung CT already has important clinical applications where it can be used to diagnose concomitant pathology and determine which patients with severe emphysema are appropriate for lung volume reduction procedures. Furthermore, novel quantitative analysis techniques permit objective measurements of pulmonary and extrapulmonary manifestations of the disease. These techniques can give important insights into COPD, and help explore the heterogeneity and underlying mechanisms of the condition. In time, it is hoped that these techniques can be used in clinical trials to help develop disease-specific therapy and, ultimately, as a clinical tool in identifying patients who would benefit most from new and existing treatments. This review discusses the current clinical applications for CT imaging in COPD and quantification techniques, and its potential future role in stratifying disease for optimal outcome.

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