Emphysema Severity Index (ESI) Predicts Respiratory Death in a Large Swedish General Population

13 Pages Posted: 17 Mar 2022

See all articles by Johannes Luoto

Johannes Luoto

Lunds Universitet

Sölve Elmståhl

affiliation not provided to SSRN

Massimo Pistolesi

affiliation not provided to SSRN

Per Wollmer

affiliation not provided to SSRN

Matteo Paoletti

affiliation not provided to SSRN

Maria-Elena Occhipinti

affiliation not provided to SSRN

Mats Pihlsgård

affiliation not provided to SSRN

Abstract

Recently, it has been shown and validated that presence and severity of emphysema on computed tomography could be estimated by a novel spirometry based index, the emphysema severity index(ESI). However, the clinical relevance of the index has not been established. We conducted cox-regression analyses with adjustment for age, smoking, sex, forced expiratory volume in one second (FEV1), forced vital capacity (FVC) to study whether ESI was associated with all-cause, respiratory and non-respiratory 10-year mortality. Study population was all participants with acceptable spirometry from the Gott Åldrande i Skåne study, a Swedish general population aged 65-102 years old. ESI is expressed as a continuous numeric parameter on a scale ranging from 0 to 10. Out of the 4453 participants in the main study, 3974 was included in the final analysis. Higher age, higher ESI, lower FEV1 and male sex increased hazard ratio of respiratory death. ESI was significantly correlated to respiratory death but not non-respiratory death, while high age, male sex and low FEV1 was associated with non-respiratory as well as respiratory death. Current smoking habits increased the hazard of respiratory death but did not reach significance (p 0.066) One unit increase in ESI increased hazard rate of all-cause death by 20% (p 0.0002) and hazard ratio of respiratory death by 57% (p <0.0001). The ESI is a novel clinical marker of emphysema severity that has a predictive value of respiratory death at group level.

Note:
Funding Information: None to declare.

Declaration of Interests: None to declare.

Ethics Approval Statement: The study was approved by the regional ethics committee of Lund University (2002; registration number LU 744-00) and all participants or carers provided written consent.

Keywords: COPD emphysemaspirometrymortality

Suggested Citation

Luoto, Johannes and Elmståhl, Sölve and Pistolesi, Massimo and Wollmer, Per and Paoletti, Matteo and Occhipinti, Maria-Elena and Pihlsgård, Mats, Emphysema Severity Index (ESI) Predicts Respiratory Death in a Large Swedish General Population. Available at SSRN: https://ssrn.com/abstract=4024831 or http://dx.doi.org/10.2139/ssrn.4024831

Johannes Luoto (Contact Author)

Lunds Universitet ( email )

Lund, 221 00
Sweden

Sölve Elmståhl

affiliation not provided to SSRN ( email )

No Address Available

Massimo Pistolesi

affiliation not provided to SSRN ( email )

No Address Available

Per Wollmer

affiliation not provided to SSRN ( email )

No Address Available

Matteo Paoletti

affiliation not provided to SSRN ( email )

No Address Available

Maria-Elena Occhipinti

affiliation not provided to SSRN ( email )

No Address Available

Mats Pihlsgård

affiliation not provided to SSRN ( email )

No Address Available

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