Mucus plugging in COPD linked to higher respiratory, cancer mortality risk
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Key takeaways:
- Researchers found a link between mucus plugs in at least three lung segments and respiratory and cancer mortality risks.
- This was not observed when considering cardiovascular mortality.
SAN DIEGO — Among patients with COPD, the risk for respiratory and cancer mortality went up with mucus plugging in at least three lung segments, according to research presented at the American Thoracic Society International Conference.
As Healio previously reported, all-cause mortality rates in patients with COPD rose when they had mucus plugs blocking medium- to large-sized airways.
Using data from the COPDGene cohort, the Social Security Death Index and a longitudinal follow-up program, Sofia K. Mettler, MD, senior medical resident at Mount Auburn Hospital, and colleagues analyzed 4,363 patients with COPD and CT scans to find out how mucus plugging impacts cause-specific mortality.
Researchers grouped patients according to how many lung segments they had with mucus plugging. Many patients had zero (n = 2,585; 59%), but the remaining patients either had one to two pulmonary segments with mucus plugging (n = 953; 22%) or at least three segments with mucus plugging (n = 825; 19%).
Within the total cohort, 1,769 patients (41%) died over the 9.5-year median follow-up period.
A committee was able to judge causes of death for 844 patients, and the leading cause was respiratory mortality with 402 patients. Other causes included cancer mortality with 186 patients, cardiovascular mortality with 120 patients and other/unknown mortality with 136 patients.
Following adjustment for several variables (age, sex, race, BMI, pack-years, smoking status, FEV1, airway wall thickness on CT and emphysema on CT), researchers found a heightened risk for respiratory death among those with mucus plugging in at least three segments vs. zero segments (HR = 1.24; 95% CI, 1.06-1.45).
The risk for cancer mortality was also higher in the group with at least three vs. zero segments with mucus plugging (HR = 1.9; 95% CI, 1.01-3.57).
According to researchers, the risk for cardiovascular mortality was not linked to mucus plugging.