Correlation Analysis of Goddard CT Grade of Emphysema with Pulmonary Function and Prognosis in COPD Patients_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

LiYing , LingFang ,  HuChengping , LuRongli , XiongZeng

Department of Respiratory Medicine, Xiangya Hospital of Central South University, Hunan, Changsha, 410008, China;

Corresponding author：

HuChengping, Email: huchengp28@126.com

Keywords：

Chronic obstructive pulmonary disease; Goddard score; Emphysema; Comprehensive evaluation

DOI：

10.7507/1671-6205.2015082

Video：

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Objective To explore the clinical value of Goddard CT grade for comprehensive evaluation of emphysema-type COPD. Methods A total of 150 patients with emphysema-type COPD were recruited in the study. Chest CT scan was performed with German Siemens Difinition 64-slice spiral CT machine. The Goddard scoring of lung CT manifestations was used to grade lung emphysema. Lung function indexes were measured including FEV₁, FVC, FEV₁/FVC, RV, TLC, RV/TLC, D_LCO, FEV₁% pred, FVC% pred and D_LCO% pred, etc. The correlation between Goddard scores and pulmonary function indexes were analyzed. The incidence of hospitalizations, length of hospital stay, severity of illness and complications in the previous year were compared between the patients with different Goddard CT grade. Results There were 57 cases of mild emphysema, 53 cases of moderate emphysema, and 40 cases of severe emphysema judged by Goddard scoring. The pulmonary Goddard scores were positive correlated with RV, TLC, and RV/TLC which reflecting pulmonary function (r value was 0.385, 0.349, 0.455, respectively, all P < 0.05), and negatively correlated with D_LCO and D_LCO% pred which reflecting pulmonary diffusing capacity (r value was-0.771, -0.787, respectively, P < 0.05). Compared with the mild and moderate emphysema-type patients, the incidence of hospitalization more than one time due to acute exacerbation was significantly higher (χ² value was 44.69, 25.66, respectively, P < 0.05), the average length of hospital stay was significantly longer [(13.5±4.2) d vs. (6.4±3.1) d and (9.0±3.8) d, P < 0.05] in the severe emphysema-type COPD patients. The severe emphysema-type COPD patients suffered from more severe acute exacerbation, and higher incidence of heart failure, ischemic heart disease and respiratory failure than the mild and moderate emphysema-type patients (P < 0.05). Conclusions Goddard CT grade in complement with pulmonary function evaluation can provide more comprehensive evaluation of emphysema-type COPD. The higher Goddard score is, the more frequently and severe the acute exacerbation occurs, more easily the COPD patients complicated with respiratory failure, heart failure and other complications.

Citation： LiYing, LingFang, HuChengping, LuRongli, XiongZeng. Correlation Analysis of Goddard CT Grade of Emphysema with Pulmonary Function and Prognosis in COPD Patients. Chinese Journal of Respiratory and Critical Care Medicine, 2015, 14(4): 327-331. doi: 10.7507/1671-6205.2015082 Copy

1.	GOLD Executive Committee Global strategy for diagnosis, management, and prevention of chronic obstructive pulmonary disease(Revised 2011).www.goldcopd.com.
2.	蔡柏蔷.慢性阻塞性肺疾病诊断、处理和预防全球策略(2011年修订版)解读.中华结核和呼吸杂志, 2012, 35:249-256.
3.	Han MK, Agusti A, Calverley PM, et al.Chronic obstructive pulmonary disease phenotypes:the future of COPD.Am J Respir Crit Care Med, 2010, 182:598-604.
4.	Goddard PR, Nicholson EM, Laszlo G, et al.Computed tomography in pulmonary emphysema.Clin Radiol, 1982, 33:379-387.
5.	Takahashi M, Fukuoka J, Nitta N, et al.Imaging of pulmonary emphysema:a pictorial review.Int J Chron Obstruct Pulmon Dis, 2008, 3:193-204.
6.	Wedzicha JA.The heterogeneity of chronic obstructive pulmonary disease.Thorax, 2000, 55:631-632.
7.	Agusti AG.COPD, a multicomponent disease:implications for management.Respir Med, 2005, 99:670-682.
8.	Bon JM, Leader JK, Weissfeld JL, et al.The influence of radiographic phenotype and smoking status on peripheral blood biomarker patterns in chronic obstructive pulmonary disease.PLoS One, 2009, 4:e6865.
9.	Mahler DA, Criner GJ.Assessment tools for chronic obstructive pulmonary disease:do newer metrics allow for disease modification? Proc Am Thorac Soc, 2007, 4:507-511.
10.	Mannino DM, Thorn D, Swensen A, et al.Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD.Eur Respir J, 2008, 32:962-969.
11.	Hurst JR, Vestbol J, Anzueto A, et al.Susceptibility of exacerbation in COPD.N Engl J Med, 2010, 363:2670-2671.
12.	Han MK, Kazerooni EA, Lynch DA, et al.Chronic obstructive pulmonary disease exacerbations in the COPDGene study:associated radiologic phenotypes.Radiology, 2011, 261:274-282.
13.	Benzo R, Farrell MH, Chang CC, et al.Integrating health status and survival data:the palliative effect of lung volume reduction surgery.Am J Respir Crit Care Med, 2009, 180:239-246.
14.	Kent BD, Mitchell PD, McNicholas WT.Hypoxemia in patients with COPD:cause, effects, and disease progression.Int J Chron Obstruct Pulmon Dis, 2011, 6:199-208.
15.	Rahman I.Oxidative stress, chromatin remodeling and gene transcription in inflammation and chronic lung diseases.J Biochem Mol Biol, 2003, 36:95-109.
16.	Mak JC.Pathogenesis of COPD.PartⅡ.Oxidative-antioxidative imbalance.Int J Tuberc Lung Dis, 2008, 12:368-374.
17.	Boschetto P, Miniati M, Miotto D, et al.Predominant emphysema phenotype in chronic obstructive pulmonary.Eur Respir J, 2003, 21:450-454.
18.	Damiano W, Tsang A, Kucich U, et al.Immunolocalization of elastase in human emphysematous lungs.J Clin Invest, 1986, 78:482-493.

1. GOLD Executive Committee Global strategy for diagnosis, management, and prevention of chronic obstructive pulmonary disease(Revised 2011).www.goldcopd.com.
2. 蔡柏蔷.慢性阻塞性肺疾病诊断、处理和预防全球策略(2011年修订版)解读.中华结核和呼吸杂志, 2012, 35:249-256.
3. Han MK, Agusti A, Calverley PM, et al.Chronic obstructive pulmonary disease phenotypes:the future of COPD.Am J Respir Crit Care Med, 2010, 182:598-604.
4. Goddard PR, Nicholson EM, Laszlo G, et al.Computed tomography in pulmonary emphysema.Clin Radiol, 1982, 33:379-387.
5. Takahashi M, Fukuoka J, Nitta N, et al.Imaging of pulmonary emphysema:a pictorial review.Int J Chron Obstruct Pulmon Dis, 2008, 3:193-204.
6. Wedzicha JA.The heterogeneity of chronic obstructive pulmonary disease.Thorax, 2000, 55:631-632.
7. Agusti AG.COPD, a multicomponent disease:implications for management.Respir Med, 2005, 99:670-682.
8. Bon JM, Leader JK, Weissfeld JL, et al.The influence of radiographic phenotype and smoking status on peripheral blood biomarker patterns in chronic obstructive pulmonary disease.PLoS One, 2009, 4:e6865.
9. Mahler DA, Criner GJ.Assessment tools for chronic obstructive pulmonary disease:do newer metrics allow for disease modification? Proc Am Thorac Soc, 2007, 4:507-511.
10. Mannino DM, Thorn D, Swensen A, et al.Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD.Eur Respir J, 2008, 32:962-969.
11. Hurst JR, Vestbol J, Anzueto A, et al.Susceptibility of exacerbation in COPD.N Engl J Med, 2010, 363:2670-2671.
12. Han MK, Kazerooni EA, Lynch DA, et al.Chronic obstructive pulmonary disease exacerbations in the COPDGene study:associated radiologic phenotypes.Radiology, 2011, 261:274-282.
13. Benzo R, Farrell MH, Chang CC, et al.Integrating health status and survival data:the palliative effect of lung volume reduction surgery.Am J Respir Crit Care Med, 2009, 180:239-246.
14. Kent BD, Mitchell PD, McNicholas WT.Hypoxemia in patients with COPD:cause, effects, and disease progression.Int J Chron Obstruct Pulmon Dis, 2011, 6:199-208.
15. Rahman I.Oxidative stress, chromatin remodeling and gene transcription in inflammation and chronic lung diseases.J Biochem Mol Biol, 2003, 36:95-109.
16. Mak JC.Pathogenesis of COPD.PartⅡ.Oxidative-antioxidative imbalance.Int J Tuberc Lung Dis, 2008, 12:368-374.
17. Boschetto P, Miniati M, Miotto D, et al.Predominant emphysema phenotype in chronic obstructive pulmonary.Eur Respir J, 2003, 21:450-454.
18. Damiano W, Tsang A, Kucich U, et al.Immunolocalization of elastase in human emphysematous lungs.J Clin Invest, 1986, 78:482-493.

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Correlation Analysis of Goddard CT Grade of Emphysema with Pulmonary Function and Prognosis in COPD Patients

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