Prevalenza, progressione e mortalità di alterazioni polmonari interstiziali in oltre 20.000 TC addominali e toraco-addominali non selezionate

Interstitial lung abnormalities (ILA) represent radiologic abnormalities incidentally detected on computed tomography (CT) scans, potentially associated with increased risk of progression toward frank pulmonary fibrosis and mortality. We aim at evaluating frequency, progression, and associated mortality of ILA depictable in a large cohort of unselected subjects who had undergone either abdominal CT or thoracic-abdominal CT for various clinical indications. Consecutive abdominal or thoraco-abdominal CT scans, performed on a large cohort of inpatients and outpatients without any available prior chest CT scan, were reviewed for the presence of ILA according to the Fleischner Society recommendations. Radiological progression of ILA was evaluated by comparing the first and the last available CT timepoints. Demographic and clinical data were obtained from hospital database and regional registry. Cox proportional hazards models were used to assess factors associated with hazards of ILA progression and mortality. ILA were observed in 362/21.118 (1.7%) subjects; with fibrotic ILA recognized in approximately 1% of either baseline abdominal or thoraco-abdominal CT scans. A definite progression was observed in 44.4% subjects. ILA were independently associated with either all-cause mortality (OR 4.158, 95%CI 2.2165-8.9908, p<0.0001) or mortality due to respiratory disease (OR 4.76., 95%CI 11.95, p=0009).