{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T20:01:54Z","timestamp":1771617714615,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,5,8]],"date-time":"2015-05-08T00:00:00Z","timestamp":1431043200000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Shanghai ShenKang Hospital Development Centre, China","award":["SHDC12012305"],"award-info":[{"award-number":["SHDC12012305"]}]},{"name":"The 11th National 5-year Development Plan","award":["2008BAI52B00"],"award-info":[{"award-number":["2008BAI52B00"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2015,5]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Emphysematous change on computed tomography (CT<\/jats:styled-content>) during the stable phase of chronic obstructive pulmonary disease (COPD<\/jats:styled-content>) is reported to correlate with COPD<\/jats:styled-content> prognosis. Acute exacerbation of COPD<\/jats:styled-content> (AECOPD<\/jats:styled-content>) is associated with a high risk of mortality and a poor prognosis.<\/jats:p><\/jats:sec>Aims<\/jats:title>This study aims to study the relationship between prognosis and emphysematous changes on CT<\/jats:styled-content> during an AECOPD<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>Histories were recorded, and CT<\/jats:styled-content> acquired for 106 patients who visited the emergency department for an AECOPD<\/jats:styled-content>. Emphysematous change was quantified by measuring the percentage of low\u2010attenuation areas (LAA<\/jats:styled-content>%) in the entire lung on CT<\/jats:styled-content> images with a threshold of \u2013950 Hounsfield units. Other factors that could influence AECOPD<\/jats:styled-content> prognosis were also recorded on admission and analysed. At follow ups conducted in 1 year, patient survival, the modified Medical Research Council (mMRC<\/jats:styled-content>) Dyspnoea Scale, and performance status (PS<\/jats:styled-content>) were evaluated, and a COPD<\/jats:styled-content> Assessment Test (CAT<\/jats:styled-content>) was completed.<\/jats:p><\/jats:sec>Results<\/jats:title>The 1\u2010year follow up was completed by 103 of 106 patients. The median LAA<\/jats:styled-content>% was significantly higher in non\u2010survivors (11%, n<\/jats:italic> = 16) than in survivors (5.69%, n<\/jats:italic> = 87) (P<\/jats:italic> = 0.006) at the 1\u2010year follow up. LAA<\/jats:styled-content>% was significantly correlated with mMRC<\/jats:styled-content> grade (r = 0.285, P<\/jats:italic> = 0.008), PS<\/jats:styled-content> (r = 0.397, P<\/jats:italic> < 0.001) and CAT<\/jats:styled-content> score (r = 0.27, P<\/jats:italic> = 0.017) at the 3\u2010month follow up, and with mMRC<\/jats:styled-content> grade (r = 0.405, P<\/jats:italic> < 0.001) and PS<\/jats:styled-content> (r = 0.377, P<\/jats:italic> < 0.001) at the 1\u2010year follow up. LAA<\/jats:styled-content>% > 7.5% was a significant predictor of 1\u2010year mortality, higher mMRC<\/jats:styled-content> and PS<\/jats:styled-content> at the 3\u2010month and 1\u2010year follow ups, after adjustment for other prognostic predictors.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Obvious emphysematous changes on CT<\/jats:styled-content> (LAA<\/jats:styled-content>% > 7.5%) during an AECOPD<\/jats:styled-content> predicts a poor prognosis independent of other known indicators.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.12723","type":"journal-article","created":{"date-parts":[[2015,2,14]],"date-time":"2015-02-14T01:50:54Z","timestamp":1423878654000},"page":"517-526","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Obvious emphysema on computed tomography during an acute exacerbation of chronic obstructive pulmonary disease predicts a poor prognosis"],"prefix":"10.1111","volume":"45","author":[{"given":"T.","family":"Cheng","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Ruijin Hospital North China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. Y.","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Ruijin Hospital North China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Q. J.","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Ruijin Hospital North China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Ruijin Hospital Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y. R.","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Ruijin Hospital Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Ruijin Hospital Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Ruijin Hospital Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y. Y.","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Shanghai Jiaotong University School of Medicine Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Ruijin Hospital Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Q. Y.","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Ruijin Hospital Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. C.","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Ruijin Hospital Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. 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