Ann Robinson’s research reviews—15 June 2023

Plugging the gap in COPDImaging can shed light, but also cast a shadow of doubt by identifying abnormalities of uncertain importance. A case in point are mucus plugs identified on computed tomography (CT) scans, which are common in patients with chronic obstructive pulmonary disease (COPD) and seem to correlate with lung function and quality of life measures. The mucus plugs can also cause local hypoxia, infections, and respiratory failure, but do they correlate with increased mortality? This observational study found that the CT finding of mucus plugs occluding medium to large sized airways in a wide range of COPD severity was associated with increased all-cause mortality compared with matched patients with no mucus plugs, even after adjusting for possible confounders such as sex, ethnicity, weight, smoking history, and concurrent respiratory and cardiovascular conditions (mortality of 54.1% v 34% over median follow-up of 9.5 years). The mucus plugs may prove to…
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