Areas of increased lung attenuation on computed tomography are associated with all-cause mortality in the general population. It is uncertain whether this association is attributable to interstitial lung disease (ILD).
To determine whether high attenuation areas are associated with the risk of ILD hospitalization and mortality in the general population.
We performed a cohort study of 6,808 adults aged 45-84 sampled from six communities in the United States. High attenuation areas were defined as the percentage of imaged lung volume with attenuation values between -600 and -250 Hounsfield units. An adjudication panel determined ILD hospitalization and death.
After adjudication, 52 participants had a diagnosis of ILD during 75,232 person-years (median 12.2 years) of follow-up. There were 48 hospitalizations attributable to ILD (crude rate 6.4 per 10,000 person-years). Twenty participants died due to ILD (crude rate 2.7 per 10,000 person-years). High attenuation areas were associated with an increased rate of ILD hospitalization (adjusted hazard ratio 2.6 per standard deviation increment in high attenuation areas, 95% confidence interval 1.9-3.5, p<0.001), a finding that was stronger among men, African-Americans and Hispanics. High attenuation areas were also associated with an increased rate of ILD-specific death (adjusted hazard ratio 2.3, 95% confidence interval 1.7-3.0, p<0.001). Our findings were consistent among both smokers and non-smokers.
Areas of increased lung attenuation are a novel risk factor for ILD hospitalization and mortality. Measurement of high attenuation areas on screening and diagnostic CT imaging may be warranted in at-risk adults.
This research output has an Altmetric Attention Score of 15. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 July 2025.
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Altmetric has tracked 34,518,599 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 90th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
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