Objective
Skeletal muscle size is considered a predictor of prognosis in patients with respiratory diseases including Mycobacterium avium complex lung disease. However, no research focused on its impact on prognosis in patients with pulmonary tuberculosis (TB). Thus, this study aimed to assess the association between erector spinae muscle (ESM) size and in-hospital mortality among patients with pulmonary TB.
Results
We retrospectively included 258 consecutive patients aged over 65 years old, who were admitted to the hospital for bacteriologically confirmed pulmonary TB, and all underwent chest computed tomography (CT) scan upon admission. The cross-sectional area of the ESM (ESMcsa) was measured at the lower margin of the 12th thoracic vertebra on a single-slice CT scan image and was adjusted according to body surface area (BSA). In total, 71 (28%) patients died during hospitalization. The non-survivor group had a high incidence of respiratory failure and comorbidities and lower hemoglobin and albumin levels, performance status score, and ESMcsa/BSA. Multivariate analysis revealed that low performance status score and hemoglobin and albumin levels, but not ESMcsa/BSA and body mass index, could independently predict in-hospital mortality after adjusting for age and comorbidities. Therefore, ESM size was not associated with in-hospital mortality in patients with pulmonary TB.
Purpose: To investigate important factors affecting the frequency of air trapping through observation of normal lung attenuation, and propose a cause of heterogeneous attenuation. Materials and Methods: In this ethical committee-approved study, a total of 109 patients (30 males, 79 females; mean age, 58.2 years; range, 27-81 years) were included. All patients had undergone inspiratory and expiratory chest thin-section computed tomography (CT) examinations and pulmonary function tests. Air trapping on CT images was graded subjectively. Hounsfield units (HU) lung attenuation value and lung volume were measured on CT images. All variables (age, sex, indices of pulmonary function test results, air trapping score, HU value, and rate of change in lung volume) were compared by diagnoses and air trapping findings cohorts. The correlation between lung function test results and expiratory HU attenuation were analyzed. Results: Interstitial pneumonia showed higher and bronchiolitis obliterans showed lower HU attenuation at normal and air trapping regions. The variables affecting air trapping findings were age, a ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1.0/FVC), maximal expiratory flow at 50% of forced vital capacity (MEF50), HU attenuation at normal regions, and rate of change in lung volume. Compared with expiratory HU attenuation, significant positive correlation was shown to FEV1.0/FVC and negative correlation to single-breath diffusion capacity for carbon monoxide, which was confirmed by a simple regression analysis. Conclusion: It can be suggested that lung attenuation can increase when fibrosis is advanced, and this is exaggerated when lungs are compressed.
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