Associations of the distance-saturation product and low-attenuation area percentage in pulmonary computed tomography with acute exacerbation in patients with chronic obstructive pulmonary disease.

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Title:	Associations of the distance-saturation product and low-attenuation area percentage in pulmonary computed tomography with acute exacerbation in patients with chronic obstructive pulmonary disease.
Authors:	陳冠元 Chen KY, Kuo HY, Lee KY, Feng PH, Wu SM, Chuang HC, Chen TT, Sun WL, Tseng CH, Liu WT, Cheng WH, Majumdar A, Stettler M, Tsai CY, Ho SC.
Contributors:	醫學系內科學科
Keywords:	Keywords: acute exacerbation of chronic obstructive pulmonary disease (AECOPD);chronic obstructive pulmonary disease (COPD);distance-saturation product (DSP);low-attenuation areas (LAA);modified medical research council (mMRC) scale.
Date:	2023-01
Issue Date:	2025-03-27 16:23:44 (UTC+8)
Abstract:	Abstract Background: Chronic obstructive pulmonary disease (COPD) has high global health concerns, and previous research proposed various indicators to predict mortality, such as the distance-saturation product (DSP), derived from the 6-min walk test (6MWT), and the low-attenuation area percentage (LAA%) in pulmonary computed tomographic images. However, the feasibility of using these indicators to evaluate the stability of COPD still remains to be investigated. Associations of the DSP and LAA% with other COPD-related clinical parameters are also unknown. This study, thus, aimed to explore these associations. Methods: This retrospective study enrolled 111 patients with COPD from northern Taiwan. Individuals' data we collected included results of a pulmonary function test (PFT), 6MWT, life quality survey [i.e., the modified Medical Research Council (mMRC) scale and COPD assessment test (CAT)], history of acute exacerbation of COPD (AECOPD), and LAA%. Next, the DSP was derived by the distance walked and the lowest oxygen saturation recorded during the 6MWT. In addition, the DSP and clinical phenotype grouping based on clinically significant outcomes by previous study approaches were employed for further investigation (i.e., DSP of 290 m%, LAA% of 20%, and AECOPD frequency of ?1). Mean comparisons and linear and logistic regression models were utilized to explore associations among the assessed variables. Results: The low-DSP group (<290 m%) had significantly higher values for the mMRC, CAT, AECOPD frequency, and LAA% at different lung volume scales (total, right, and left), whereas it had lower values of the PFT and 6MWT parameters compared to the high-DSP group. Significant associations (with high odds ratios) were observed of the mMRC, CAT, AECOPD frequency, and PFT with low- and high-DSP groupings. Next, the risk of having AECOPD was associated with the mMRC, CAT, DSP, and LAA% (for the total, right, and left lungs). Conclusion: A lower value of the DSP was related to a greater worsening of symptoms, more-frequent exacerbations, poorer pulmonary function, and more-severe emphysema (higher LAA%). These readily determined parameters, including the DSP and LAA%, can serve as indicators for assessing the COPD clinical course and may can serve as a guide to corresponding treatments.
Relation:	Front Med (Lausanne). 2023 Jan 4;9:1047420. doi: 10.3389/fmed.2022.1047420. PMID: 36687440; PMCID: PMC9846059
Description:	【112 新聘】臺北醫學大學教師升等專門著作職別：專任送審等級：助理教授著作送審
Data Type:	article
Appears in Collections:	[Scholarly output for promotion] 112 [Department of Internal Medicine] Periodical Article

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