Obstructive Lung Diseases |

Phenotyping of COPD Using the Modified Bhalla Scoring System for High-Resolution Computed Tomography FREE TO VIEW

Baykal Tulek, MD; Ali Sami Kivrak, MD; Seda Ozbek, MD; Fikret Kanat, MD; Mecit Süerdem, MD
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Selcuk University, Faculty of Medicine, Dept. of Chest Diseases, Konya, Turkey

Chest. 2013;144(4_MeetingAbstracts):722A. doi:10.1378/chest.1676757
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SESSION TITLE: COPD Severity Metrics

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, October 27, 2013 at 03:00 PM - 04:00 PM

PURPOSE: Identification of different phenotypes in chronic obstructive pulmonary disease (COPD) is important for both therapeutic options and clinical outcome of the disease. This study aimed to characterize the phenotypes of COPD patients according to high-resolution computed tomography (HRCT) findings and to correlate HRCT scores obtained by the modified Bhalla scoring system with clinical and physiological indicators of systemic inflammation.

METHODS: The study included 80 consecutive patients with stable COPD. HRCT scans were evaluated according to the modified Bhalla scoring system by two independent radiologists.

RESULTS: Fifty four patients exhibited morphological changes on HRCT examination while 26 had no pathological findings. Patients with HRCT findings had lower spirometric measurements, higher levels of inflammation and reported more exacerbations in the previous year compared with no findings on HRCT. Patients with morphological changes were distributed over three groups according to their HRCT phenotypes: Emphysema (E) only, E and bronchiectasis (B)/peribronchial thickening (PBT) together, and only B/PBT. FVC, FEV1, FEV1/FVC values, CRP levels and exacerbation numbers among groups were significantly different. Pairwise comparisons between the E only and E plus B/PBT groups showed significantly lower FVC, FEV1 and FEV1/FVC and higher CRP levels and exacerbation numbers in the latter. The comparison between the E plus B/PBT and the B/PBT only patients could not evidence a significant difference. An inverse correlation was found between the total HRCT score and FVC, FEV1 and FEV1/FVC, while it was positive with CRP, ESR and exacerbations numbers.

CONCLUSIONS: Our study exposes the intimate relationship between phenotypes characterized by HRCT and the scoring for morphologic abnormalities on one hand and the clinical and functional parameters and inflammatory markers on the other.

CLINICAL IMPLICATIONS: The inclusion of HRCT among routine examinations for COPD may provide significant benefits both in management and prognosis of the COPD patients.

DISCLOSURE: The following authors have nothing to disclose: Baykal Tulek, Ali Sami Kivrak, Seda Ozbek, Fikret Kanat, Mecit Süerdem

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