
A study examined smokers without known interstitial lung disease (ILD) in the COPDGene study, assessing the impact of fibrotic interstitial lung abnormalities (ILA) and emphysema progression on mortality. Of the 4,450 subjects, 18.9% experienced emphysema progression, 11.5% fibrosis progression, and 6.2% both. The combined progression of emphysema and fibrosis had the highest mortality risk (HR 2.18), emphasizing their clinical relevance. Even a slight increase in quantified pulmonary fibrosis (0.58% of total lung) was associated with increased mortality. This study underscores the importance of quantifying lung changes in smokers for prognostic evaluation.
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