High-Attenuation Areas on Chest Computed Tomography and Clinical Respiratory Outcomes in Community-Dwelling Adults

Rationale: Areas of increased lung attenuation visualized by 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).Objectives: To determine whether high-attenuation areas are associated with the risk of ILD hospitalization and mortality in the general population.Methods: We performed a cohort study of 6,808 adults aged 45–84 years 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.Measurements and Main Results: After adjudication, 52 participants had a diagnosis of ILD during 75,232 person-years (median, 12.2 yr) of follow-up. There were 48 hospitalizations attributable to ILD (crude rate, 6.4 per 10,000 person-years). Twenty participants died as a result of ILD (crude rate, 2.7 per ...