COPD-associated mucus plugs increase mortality risk: JAMA

Written By : Jacinthlyn Sylvia |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-05-25T20:00:34+05:30 | Updated On 26 May 2023 1:07 PM IST

A new study by Alejandro Diaz and team showed that the presence of mucus plugs that blocked medium- to large-sized airways on chest computed tomography (CT) images in chronic obstructive pulmonary disease (COPD) participants was linked with increased all-cause mortality compared to those without mucus plugging.The findings of this study were published in the Journal of American Medical Association.

Airway mucus plugs are prevalent in individuals with chronic obstructive pulmonary disease (COPD); nevertheless, the relationship between airway mucus plugging and mortality in COPD patients remains uncertain. As a result, this study was carried out to see if airway mucus plugs seen on chest computed tomography were related with higher all-cause mortality.

This was an observational retrospective study of prospectively gathered data from COPD patients in the Genetic Epidemiology of COPD cohort. Participants ranged in age from 45 to 80 years old, were non-Hispanic Black or White, and had smoked at least 10 pack-years. Between November 2007 and April 2011, participants were registered at 21 centres around the United States and were followed up on until August 31, 2022. Mucus plugs that totally obstructed airways on chest CT scans, detected in medium- to large-sized airways, and classified as impacting zero, one to two, or three or more lung segments. The primary outcome was all-cause death, which was analysed using proportional hazard regression.

The key findings of this study were:

The primary analysis comprised 4363 of the 4483 patients with COPD.

Mucus plugs were found in 0, 1 to 2, and 3 or more lung segments in a total of 2585 (59.3%), 953 (21.8%), and 825 (18.9%) patients, respectively.

During a 9.5-year median follow-up, 1769 participants (40.6%) died.

Participants with mucus plugs in 0, 1 to 2, and 3 or more lung segments had death rates of 34.0%, 46.7%, and 54.1%, respectively.

Mucus plugs in 1 to 2 versus 0 lung segments and 3 or more vs 0 lung segments have been linked with an adjusted hazard ratio of mortality of 1.15 and 1.24, respectively.

Reference:

Diaz, A. A., Orejas, J. L., Grumley, S., Nath, H. P., Wang, W., Dolliver, W. R., Yen, A., Kligerman, S. J., Jacobs, K., Manapragada, P. P., Abozeed, M., Aziz, M. U., Zahid, M., Han, M. K., … San José Estépar, R. (2023). Airway-Occluding Mucus Plugs and Mortality in Patients With Chronic Obstructive Pulmonary Disease. In JAMA. American Medical Association (AMA). https://doi.org/10.1001/jama.2023.2065

Mucus plugchronic obstructive pulmonary disorderJAMA Network

Source : JAMA Network

Jacinthlyn Sylvia

Neuroscience Masters graduate

Jacinthlyn Sylvia, a Neuroscience Master's graduate from Chennai has worked extensively in deciphering the neurobiology of cognition and motor control in aging. She also has spread-out exposure to Neurosurgery from her Bachelor’s. She is currently involved in active Neuro-Oncology research. She is an upcoming neuroscientist with a fiery passion for writing. Her news cover at Medical Dialogues feature recent discoveries and updates from the healthcare and biomedical research fields. She can be reached at editorial@medicaldialogues.in

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751