Psoas Muscle Density Evaluated by Chest CT and Long-Term Mortality in COPD Patients |
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| Affiliation: | 1. Radiology Department, Clínica Universidad de Navarra, Pamplona, Spain;2. Pulmonary Department, Hospital Ntra Sra de Candelaria, Tenerife, Spain;3. Respiratory Research Unit, Hospital Ntra Sra de Candelaria, Tenerife, Spain;4. Pulmonary Department, Hospital Universitario Doctor Negrín, Las Palmas, Spain;5. Respirology and Sleep Division, Queen''s University, Kingston, Canada;6. Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain;7. Pulmonary Department, Hospital Universitario Miguel Servet, Instituto Aragonés Ciencias Salud & CIBERES, Zaragoza, Spain;8. Pulmonary Department, Baystate Medical Center, Springfield, MA, USA;9. Pulmonary Department, Brigham and Women''s Hospital, Harvard Medical School, Boston, MA, USA |
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| Abstract: | RationalePoor muscle quality in COPD patients relates to exercise intolerance and mortality. Muscle quality can be estimated on computed tomography (CT) by estimating psoas density (PsD). We tested the hypothesis that PsD is lower in COPD patients than in controls and relates to all-cause mortality.MethodsAt baseline, PsD was measured using axial low-dose chest CT images in 220 COPD patients, 80% men, who were 65 ± 8 years old with mild to severe airflow limitation and in a control group of 58 subjects matched by age, sex, body mass index (BMI) and body surface area (BSA). COPD patients were prospectively followed for 76.5 (48–119) months. Anthropometrics, smoking history, BMI, dyspnoea, lung function, exercise capacity, BODE index and exacerbations history were recorded. Cox proportional risk analysis determined the factors more strongly associated with long-term mortality.ResultsPsD was lower in COPD patients than in controls (40.5 vs 42.5, p = 0.045). During the follow-up, 54 (24.5%) deaths occurred in the COPD group. PsD as well as age, sex, pack-year history, FEV1%, 6MWD, mMRC, BODE index, were independently associated with mortality. Multivariate analysis showed that age (HR 1.06; 95% CI 1.02–1.12, p = 0.006) and CT-assessed PsD (HR 0.97; 95%CI 0.94–0.99, p = 0.023) were the variables independently associated with all-cause mortality.ConclusionsIn COPD patients with mild to severe airflow limitation, chest CT-assessed psoas muscle density was lower than in matched controls and independently associated with long-term mortality. Muscle quality using the easy to evaluate psoas muscle density from chest CT may provide clinicians with important prognostic information in COPD. |
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| Keywords: | COPD Psoas Density Mortality EPOC Psoas Densidad Mortalidad |
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