Chest Computed Tomography Scores Are Predictive of Survival in Patients with Cystic Fibrosis Awaiting Lung Transplantation
Up to one-third of patients with cystic fibrosis (CF) awaiting lung transplantation (LTX) die while waiting. Inclusion of computed tomography (CT) scores may improve survival prediction models such as the lung allocation score (LAS). This study investigated the association between CT and survival in...
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| Veröffentlicht in: | American journal of respiratory and critical care medicine 2012-05, Vol.185 (10), p.1096-1103 |
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| creator | LOEVE, Martine HOP, WimC J DE BRUIJNE, Marleen VAN HAL, Peter T. W ROBINSON, Phil AITKEN, Moira L DODD, Jonathan D TIDDENS, Harm A. W. M |
| description | Up to one-third of patients with cystic fibrosis (CF) awaiting lung transplantation (LTX) die while waiting. Inclusion of computed tomography (CT) scores may improve survival prediction models such as the lung allocation score (LAS).
This study investigated the association between CT and survival in patients with CF screened for LTX.
Clinical data and chest CTs of 411 patients with CF screened for LTX between 1990 and 2005 were collected from 17 centers. CTs were scored with the Severe Advanced Lung Disease (SALD) four-category scoring system, including the components infection/inflammation (INF), air trapping/hypoperfusion (AT), normal/hyperperfusion (NOR), and bulla/cysts (BUL). The volume of each component was computed using semiautomated software. Survival analysis included Kaplan-Meier curves and Cox regression models.
Three hundred and sixty-six (186 males) of 411 patients entered the waiting list (median age, 23 yr; range, 5-58 yr). Subsequently, 67 of 366 (18%) died while waiting, 263 of 366 (72%) underwent LTX, and 36 of 366 (10%) were awaiting LTX at the census date. INF and LAS were significantly associated with waiting list mortality in univariate analyses. The multivariate Cox model including INF and LAS grouped in tertiles, and comparing tertiles 2 and 3 with tertile 1, showed waiting list mortality hazard ratios of 1.62 (95% confidence interval [95% CI], 0.78-3.36; P = 0.19) and 2.65 (95% CI, 1.35-5.20; P = 0.005) for INF, and 1.42 (95% CI, 0.63-3.24; P = 0.40), and 2.32 (95% CI, 1.17-4.60; P = 0.016) for LAS, respectively. These results indicated that INF and LAS had significant, independent predictive value for survival.
CT score INF correlates with survival, and adds to the predictive value of LAS. |
| doi_str_mv | 10.1164/rccm.201111-2065OC |
| format | Article |
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This study investigated the association between CT and survival in patients with CF screened for LTX.
Clinical data and chest CTs of 411 patients with CF screened for LTX between 1990 and 2005 were collected from 17 centers. CTs were scored with the Severe Advanced Lung Disease (SALD) four-category scoring system, including the components infection/inflammation (INF), air trapping/hypoperfusion (AT), normal/hyperperfusion (NOR), and bulla/cysts (BUL). The volume of each component was computed using semiautomated software. Survival analysis included Kaplan-Meier curves and Cox regression models.
Three hundred and sixty-six (186 males) of 411 patients entered the waiting list (median age, 23 yr; range, 5-58 yr). Subsequently, 67 of 366 (18%) died while waiting, 263 of 366 (72%) underwent LTX, and 36 of 366 (10%) were awaiting LTX at the census date. INF and LAS were significantly associated with waiting list mortality in univariate analyses. The multivariate Cox model including INF and LAS grouped in tertiles, and comparing tertiles 2 and 3 with tertile 1, showed waiting list mortality hazard ratios of 1.62 (95% confidence interval [95% CI], 0.78-3.36; P = 0.19) and 2.65 (95% CI, 1.35-5.20; P = 0.005) for INF, and 1.42 (95% CI, 0.63-3.24; P = 0.40), and 2.32 (95% CI, 1.17-4.60; P = 0.016) for LAS, respectively. These results indicated that INF and LAS had significant, independent predictive value for survival.
CT score INF correlates with survival, and adds to the predictive value of LAS.</description><identifier>ISSN: 1073-449X</identifier><identifier>EISSN: 1535-4970</identifier><identifier>DOI: 10.1164/rccm.201111-2065OC</identifier><identifier>PMID: 22403801</identifier><language>eng</language><publisher>New York, NY: American Thoracic Society</publisher><subject>Adolescent ; Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Child ; Child, Preschool ; Cohort Studies ; Cystic fibrosis ; Cystic Fibrosis - diagnostic imaging ; Cystic Fibrosis - mortality ; Cystic Fibrosis - surgery ; Cysts ; Decision Support Techniques ; Female ; Humans ; Intensive care medicine ; Investigative techniques, diagnostic techniques (general aspects) ; Kaplan-Meier Estimate ; Lung diseases ; Lung Transplantation ; Lung transplants ; Male ; Medical sciences ; Middle Aged ; Mortality ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Quality of life ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Respiratory system ; Severity of Illness Index ; Software ; Survival analysis ; Tomography ; Tomography, X-Ray Computed ; Waiting Lists - mortality ; Young Adult</subject><ispartof>American journal of respiratory and critical care medicine, 2012-05, Vol.185 (10), p.1096-1103</ispartof><rights>2015 INIST-CNRS</rights><rights>Copyright American Thoracic Society May 15, 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c361t-f12707dc798162116a436604cb8262f6db7008569fa300966831ff29cd058c293</citedby><cites>FETCH-LOGICAL-c361t-f12707dc798162116a436604cb8262f6db7008569fa300966831ff29cd058c293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4011,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25856464$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22403801$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LOEVE, Martine</creatorcontrib><creatorcontrib>HOP, WimC J</creatorcontrib><creatorcontrib>DE BRUIJNE, Marleen</creatorcontrib><creatorcontrib>VAN HAL, Peter T. W</creatorcontrib><creatorcontrib>ROBINSON, Phil</creatorcontrib><creatorcontrib>AITKEN, Moira L</creatorcontrib><creatorcontrib>DODD, Jonathan D</creatorcontrib><creatorcontrib>TIDDENS, Harm A. W. M</creatorcontrib><creatorcontrib>Computed Tomography Cystic Fibrosis Survival Study Group</creatorcontrib><title>Chest Computed Tomography Scores Are Predictive of Survival in Patients with Cystic Fibrosis Awaiting Lung Transplantation</title><title>American journal of respiratory and critical care medicine</title><addtitle>Am J Respir Crit Care Med</addtitle><description>Up to one-third of patients with cystic fibrosis (CF) awaiting lung transplantation (LTX) die while waiting. Inclusion of computed tomography (CT) scores may improve survival prediction models such as the lung allocation score (LAS).
This study investigated the association between CT and survival in patients with CF screened for LTX.
Clinical data and chest CTs of 411 patients with CF screened for LTX between 1990 and 2005 were collected from 17 centers. CTs were scored with the Severe Advanced Lung Disease (SALD) four-category scoring system, including the components infection/inflammation (INF), air trapping/hypoperfusion (AT), normal/hyperperfusion (NOR), and bulla/cysts (BUL). The volume of each component was computed using semiautomated software. Survival analysis included Kaplan-Meier curves and Cox regression models.
Three hundred and sixty-six (186 males) of 411 patients entered the waiting list (median age, 23 yr; range, 5-58 yr). Subsequently, 67 of 366 (18%) died while waiting, 263 of 366 (72%) underwent LTX, and 36 of 366 (10%) were awaiting LTX at the census date. INF and LAS were significantly associated with waiting list mortality in univariate analyses. The multivariate Cox model including INF and LAS grouped in tertiles, and comparing tertiles 2 and 3 with tertile 1, showed waiting list mortality hazard ratios of 1.62 (95% confidence interval [95% CI], 0.78-3.36; P = 0.19) and 2.65 (95% CI, 1.35-5.20; P = 0.005) for INF, and 1.42 (95% CI, 0.63-3.24; P = 0.40), and 2.32 (95% CI, 1.17-4.60; P = 0.016) for LAS, respectively. These results indicated that INF and LAS had significant, independent predictive value for survival.
CT score INF correlates with survival, and adds to the predictive value of LAS.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cohort Studies</subject><subject>Cystic fibrosis</subject><subject>Cystic Fibrosis - diagnostic imaging</subject><subject>Cystic Fibrosis - mortality</subject><subject>Cystic Fibrosis - surgery</subject><subject>Cysts</subject><subject>Decision Support Techniques</subject><subject>Female</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Kaplan-Meier Estimate</subject><subject>Lung diseases</subject><subject>Lung Transplantation</subject><subject>Lung transplants</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Quality of life</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Respiratory system</subject><subject>Severity of Illness Index</subject><subject>Software</subject><subject>Survival analysis</subject><subject>Tomography</subject><subject>Tomography, X-Ray Computed</subject><subject>Waiting Lists - mortality</subject><subject>Young Adult</subject><issn>1073-449X</issn><issn>1535-4970</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkUtr3DAUhUVpaR7tH-giCEogG6dXD8vyMpikCQwkkCl0ZzSylFGwLUeSJ0x_fTTMpIVqId3Fdw736CD0jcAlIYL_CFoPlxRIPgUFUd43H9AxKVlZ8LqCj3mGihWc17-P0EmMzwCESgKf0RGlHJgEcoz-NGsTE278MM3JdHjpB_8U1LTe4kftg4n4Khj8EEzndHIbg73Fj3PYuI3qsRvxg0rOjCniV5fWuNnG5DS-cavgo8vaV-WSG5_wYs7XMqgxTr0aUxb58Qv6ZFUfzdfDe4p-3Vwvm9ticf_zrrlaFJoJkgpLaAVVp6taEkFzcMWZEMD1SlJBrehWFYAsRW0VA6iFkIxYS2vdQSk1rdkputj7TsG_zDltO7ioTZ8XMX6OLQFKy7IGxjP6_T_02c9hzNtlinAqqYSdId1TOqeMwdh2Cm5QYZuhdtdMu2um3TfT7pvJorOD9bwaTPdX8l5FBs4PgIpa9TZ_lnbxH1fmjFxw9gaOP5ag</recordid><startdate>20120515</startdate><enddate>20120515</enddate><creator>LOEVE, Martine</creator><creator>HOP, WimC J</creator><creator>DE BRUIJNE, Marleen</creator><creator>VAN HAL, Peter T. 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Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cohort Studies</topic><topic>Cystic fibrosis</topic><topic>Cystic Fibrosis - diagnostic imaging</topic><topic>Cystic Fibrosis - mortality</topic><topic>Cystic Fibrosis - surgery</topic><topic>Cysts</topic><topic>Decision Support Techniques</topic><topic>Female</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Kaplan-Meier Estimate</topic><topic>Lung diseases</topic><topic>Lung Transplantation</topic><topic>Lung transplants</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Quality of life</topic><topic>Radiodiagnosis. Nmr imagery. 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W</au><au>ROBINSON, Phil</au><au>AITKEN, Moira L</au><au>DODD, Jonathan D</au><au>TIDDENS, Harm A. W. M</au><aucorp>Computed Tomography Cystic Fibrosis Survival Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chest Computed Tomography Scores Are Predictive of Survival in Patients with Cystic Fibrosis Awaiting Lung Transplantation</atitle><jtitle>American journal of respiratory and critical care medicine</jtitle><addtitle>Am J Respir Crit Care Med</addtitle><date>2012-05-15</date><risdate>2012</risdate><volume>185</volume><issue>10</issue><spage>1096</spage><epage>1103</epage><pages>1096-1103</pages><issn>1073-449X</issn><eissn>1535-4970</eissn><abstract>Up to one-third of patients with cystic fibrosis (CF) awaiting lung transplantation (LTX) die while waiting. Inclusion of computed tomography (CT) scores may improve survival prediction models such as the lung allocation score (LAS).
This study investigated the association between CT and survival in patients with CF screened for LTX.
Clinical data and chest CTs of 411 patients with CF screened for LTX between 1990 and 2005 were collected from 17 centers. CTs were scored with the Severe Advanced Lung Disease (SALD) four-category scoring system, including the components infection/inflammation (INF), air trapping/hypoperfusion (AT), normal/hyperperfusion (NOR), and bulla/cysts (BUL). The volume of each component was computed using semiautomated software. Survival analysis included Kaplan-Meier curves and Cox regression models.
Three hundred and sixty-six (186 males) of 411 patients entered the waiting list (median age, 23 yr; range, 5-58 yr). Subsequently, 67 of 366 (18%) died while waiting, 263 of 366 (72%) underwent LTX, and 36 of 366 (10%) were awaiting LTX at the census date. INF and LAS were significantly associated with waiting list mortality in univariate analyses. The multivariate Cox model including INF and LAS grouped in tertiles, and comparing tertiles 2 and 3 with tertile 1, showed waiting list mortality hazard ratios of 1.62 (95% confidence interval [95% CI], 0.78-3.36; P = 0.19) and 2.65 (95% CI, 1.35-5.20; P = 0.005) for INF, and 1.42 (95% CI, 0.63-3.24; P = 0.40), and 2.32 (95% CI, 1.17-4.60; P = 0.016) for LAS, respectively. These results indicated that INF and LAS had significant, independent predictive value for survival.
CT score INF correlates with survival, and adds to the predictive value of LAS.</abstract><cop>New York, NY</cop><pub>American Thoracic Society</pub><pmid>22403801</pmid><doi>10.1164/rccm.201111-2065OC</doi><tpages>8</tpages></addata></record> |
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| source | MEDLINE; American Thoracic Society (ATS) Journals Online; Alma/SFX Local Collection; Journals@Ovid Complete; EZB* |
| subjects | Adolescent Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Child Child, Preschool Cohort Studies Cystic fibrosis Cystic Fibrosis - diagnostic imaging Cystic Fibrosis - mortality Cystic Fibrosis - surgery Cysts Decision Support Techniques Female Humans Intensive care medicine Investigative techniques, diagnostic techniques (general aspects) Kaplan-Meier Estimate Lung diseases Lung Transplantation Lung transplants Male Medical sciences Middle Aged Mortality Multivariate Analysis Prognosis Proportional Hazards Models Quality of life Radiodiagnosis. Nmr imagery. Nmr spectrometry Respiratory system Severity of Illness Index Software Survival analysis Tomography Tomography, X-Ray Computed Waiting Lists - mortality Young Adult |
| title | Chest Computed Tomography Scores Are Predictive of Survival in Patients with Cystic Fibrosis Awaiting Lung Transplantation |
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