Baseline Emphysema at LDCT Predictive of All-Cause, COPD, CVD Mortality

Background: Emphysema is characterized by abnormal, permanent enlargement of air spaces beyond the terminal bronchiole with alveolar wall destruction, without evident fibrosis. In lung cancer screening participants in New York state, about 29% had emphysema, which was predictive of chronic obstructive pulmonary disease (COPD)–related mortality. Emphysema has prognostic value independent of spirometric diagnosis of COPD and even in individuals without heavy smoking or known lung disease, and it is associated with exacerbations, decline of pulmonary function, lung cancer, and all-cause mortality, but long-term data are limited, and the prognostic value of baseline visual emphysema scoring at low-dose CT (LDCT) in lung cancer screening cohorts is unknown. Objective: To evaluate whether a single visual emphysema score at LDCT is predictive of 25-year mortality from all causes, COPD, and CVD. Design: Prospective cohort study. Participants: Symptomatic smokers aged 40 to 85 years und more...