Thomas Grydeland
Haukeland University Hospital
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Featured researches published by Thomas Grydeland.
American Journal of Respiratory and Critical Care Medicine | 2010
Thomas Grydeland; Asger Dirksen; Harvey O. Coxson; Tomas Eagan; Einar Thorsen; Sreekumar G. Pillai; Sanjay Sharma; Geir Egil Eide; Amund Gulsvik; Per Bakke
RATIONALE There is limited knowledge about the relationship between respiratory symptoms and quantitative high-resolution computed tomography measures of emphysema and airway wall thickness. OBJECTIVES To describe the ability of these measures of emphysema and airway wall thickness to predict respiratory symptoms in subjects with and without chronic obstructive pulmonary disease (COPD). METHODS We included 463 subjects with chronic obstructive pulmonary disease (COPD) (65% men) and 488 subjects without COPD (53% men). All subjects were current or ex-smokers older than 40 years. They underwent spirometry and high-resolution computed tomography examination, and completed an American Thoracic Society questionnaire on respiratory symptoms. MEASUREMENTS AND MAIN RESULTS Median (25th percentile, 75th percentile) percent low-attenuation areas less than -950 Hounsfield units (%LAA) was 7.0 (2.2, 17.8) in subjects with COPD and 0.5 (0.2, 1.3) in subjects without COPD. Mean (SD) standardized airway wall thickness (AWT) at an internal perimeter of 10 mm (AWT-Pi10) was 4.94 (0.33) mm in subjects with COPD and 4.77 (0.29) in subjects without COPD. Both %LAA and AWT-Pi10 were independently and significantly related to the level of dyspnea among subjects with COPD, even after adjustments for percent predicted FEV(1). AWT-Pi10 was significantly related to cough and wheezing in subjects with COPD, and to wheezing in subjects without COPD. Odds ratios (95% confidence intervals) for increased dyspnea in subjects with COPD and in subjects without COPD were 1.9 (1.5-2.3) and 1.9 (0.6-6.6) per 10% increase in %LAA, and 1.07 (1.01-1.14) and 1.11 (0.99-1.24) per 0.1-mm increase in AWT-Pi10, respectively. CONCLUSIONS Quantitative computed tomography assessment of the lung parenchyma and airways may be used to explain the presence of respiratory symptoms beyond the information offered by spirometry.
European Respiratory Journal | 2009
Thomas Grydeland; Asger Dirksen; Harvey O. Coxson; Sreekumar G. Pillai; Sunita Sharma; Geir Egil Eide; Amund Gulsvik; Per Bakke
We investigated how quantitative high-resolution computed tomography (HRCT) measures of emphysema and airway wall thickness (AWT) vary with sex, age and smoking history. We included 463 chronic obstructive pulmonary disease (COPD) cases and 431 controls. All included subjects were current or ex-smokers aged ≥40 yrs, and all underwent spirometry and HRCT examination. The HRCT images were quantitatively assessed, providing indices on lung density and airway dimensions. The median (25–75th percentile) %LAA950 (% low-attenuation area < -950 HU) was 8.9 (3–19) and 4.7 (1–16) in male and female COPD cases, respectively, and 0.71 (0.3–1.6) and 0.32 (0.1–0.8) in male and female controls, respectively. %LAA950 was higher in ex-smokers and increased with increasing age and with increasing number of pack-years. The mean±sd standardised AWT was 0.504±0.030 and 0.474±0.031 in male and female COPD cases, respectively, and 0.488±0.028 and 0.463±0.025 in male and female controls, respectively. AWT decreased with increasing age in cases, and increased with the degree of current smoking in all subjects. We found significant differences in quantitative HRCT measures of emphysema and AWT between varying sex, age and smoking groups of both control and COPD subjects.
American Journal of Respiratory and Critical Care Medicine | 2013
Ane Johannessen; Trude Duelien Skorge; Matteo Bottai; Thomas Grydeland; Roy Miodini Nilsen; Harvey O. Coxson; Asger Dirksen; Ernst Omenaas; Amund Gulsvik; Per Bakke
RATIONALE There is limited knowledge of the prognostic value of quantitative computed tomography (CT) measures of emphysema and airway wall thickness (AWT) on mortality. OBJECTIVES To examine 8-year mortality in relation to CT-measured emphysema and AWT, and assess if potential impact of these predictors remained after adjustment for lung function. METHODS In the Norwegian GenKOLS study of 2003-2005, 947 ever-smokers (49% with COPD) aged 40-85 years performed spirometry and CT examination. Mortality data from 2003-2011 were gathered from the Norwegian Cause of Death Registry. CT emphysema % low-attenuation areas (%LAA) and standardized measure for AWT (AWT-Pi10) were main predictors. We performed Laplace regression for survival data, estimating survival time for specified population percentiles within each emphysema category. Models were adjusted for sex, FEV1, COPD status, age, body mass index, smoking, and inflation level. MEASUREMENTS AND MAIN RESULTS During 8-year follow-up all-cause mortality rate was 15%. Although 4% of the subjects with %LAA less than 3 died, 18% with %LAA 3-10 and 44% with %LAA greater than or equal to 10 died. After adjustment, the comparable percentile subjects with medium and high emphysema had 19 months shorter survival than subjects who died in the lowest emphysema category. Subjects with %LAA greater than or equal to 10 had 33 and 37 months shorter survival than the lowest emphysema category with regard to respiratory and cardiovascular mortality, respectively. No significant associations were found between %LAA and cancer and lung cancer mortality. AWT did not predict mortality independently, but a positive interaction with emphysema was observed. CONCLUSIONS AWT affected mortality with increasing degree of emphysema, whereas CT measure of emphysema was a strong independent mortality predictor.
Pulmonary Medicine | 2011
Erica P.A. Rutten; Thomas Grydeland; Sreekumar G. Pillai; Scott Wagers; Asger Dirksen; Harvey O. Coxson; Amund Gulsvik; Emiel F.M. Wouters; Per Bakke
The objective of the present study was to determine the association between CT phenotypes—emphysema by low attenuation area and bronchitis by airway wall thickness—and body composition parameters in a large cohort of subjects with and without COPD. In 452 COPD subjects and 459 subjects without COPD, CT scans were performed to determine emphysema (%LAA), airway wall thickness (AWT-Pi10), and lung mass. Muscle wasting based on FFMI was assessed by bioelectrical impedance. In both the men and women with COPD, FFMI was negatively associated with %LAA. FMI was positively associated with AWT-Pi10 in both subjects with and without COPD. Among the subjects with muscle wasting, the percentage emphysema was high, but the predictive value was moderate. In conclusion, the present study strengthens the hypothesis that the subgroup of COPD cases with muscle wasting have emphysema. Airway wall thickness is positively associated with fat mass index in both subjects with and without COPD.
Clinical Respiratory Journal | 2010
Inga-Cecilie Sørheim; Ane Johannessen; Thomas Grydeland; Ernst Omenaas; Amund Gulsvik; Per Bakke
Introduction: Sampling is regarded as crucial to the validity of case–control studies. Ideally, cases and controls should be selected from the same source population, but deviations from this approach are often seen.
European Journal of Radiology | 2015
Andreas Thelle; Miriam Gjerdevik; Thomas Grydeland; Trude Duelien Skorge; Tore Wentzel-Larsen; Per Bakke
PURPOSE Detailed and reliable methods may be important for discussions on the importance of pneumothorax size in clinical decision-making. Rheas method is widely used to estimate pneumothorax size in percent based on chest X-rays (CXRs) from three measure points. Chois addendum is used for anterioposterior projections. The aim of this study was to examine the intrarater and interrater reliability of the Rhea and Choi method using digital CXR in the ward based PACS monitors. MATERIALS AND METHODS Three physicians examined a retrospective series of 80 digital CXRs showing pneumothorax, using Rhea and Chois method, then repeated in a random order two weeks later. We used the analysis of variance technique by Eliasziw et al. to assess the intrarater and interrater reliability in altogether 480 estimations of pneumothorax size. RESULTS Estimated pneumothorax sizes ranged between 5% and 100%. The intrarater reliability coefficient was 0.98 (95% one-sided lower-limit confidence interval C 0.96), and the interrater reliability coefficient was 0.95 (95% one-sided lower-limit confidence interval 0.93). CONCLUSION This study has shown that the Rhea and Choi method for calculating pneumothorax size has high intrarater and interrater reliability. These results are valid across gender, side of pneumothorax and whether the patient is diagnosed with primary or secondary pneumothorax.
European Clinical Respiratory Journal | 2015
Eirunn Waatevik Saure; Per Bakke; Tomas Eagan; Marianne Aanerud; Robert L. Jensen; Thomas Grydeland; Ane Johannessen; Roy Miodini Nilsen; Einar Thorsen; Jon A. Hardie
Background Decreased diffusing capacity of the lung for carbon monoxide (DLCO) is associated with emphysema. DLCO is also related to decreased arterial oxygen tension (PaO2), but there are limited data on associations between PaO2 and computed tomography (CT) derived measures of emphysema and airway wall thickness. Objective To examine whether CT measures of emphysema and airway wall thickness are associated with level of arterial oxygen tension beyond that provided by measurements of diffusion capacity and spirometry. Methods The study sample consisted of 271 smoking or ex-smoking COPD patients from the Bergen COPD Cohort Study examined in 2007–2008. Emphysema was assessed as percent of low-attenuation areas<−950 Hounsfield units (%LAA), and airway wall thickness as standardised measure at an internal perimeter of 10 mm (AWT-Pi10). Multiple linear regression models were fitted with PaO2 as the outcome variable, and %LAA, AWT-Pi10, DLCO and carbon monoxide transfer coefficient (KCO) as main explanatory variables. The models were adjusted for sex, age, smoking status, and haemoglobin concentration, as well as forced expiratory volume in one second (FEV1). Results Sixty two per cent of the subjects were men, mean (SD) age was 64 (7) years, mean (SD) FEV1 in percent predicted was 50 (15)%, and mean PaO2 (SD) was 9.3 (1.1) kPa. The adjusted regression coefficient (CI) for PaO2 was –0.32 (−0.04–(−0.019)) per 10% increase in %LAA (p<0.01). When diffusion capacity and FEV1 were added to the model, respectively, the association lost its statistical significance. No relationship between airway wall thickness and PaO2 was found. Conclusion CT assessment of airway wall thickness is not associated with arterial oxygen tension in COPD patients. Emphysema score measured by chest CT, is related to decreased PaO2, but cannot replace measurements of diffusion capacity in the clinical evaluation of hypoxaemia.
Annals of the American Thoracic Society | 2015
Miriam Gjerdevik; Thomas Grydeland; George R. Washko; Harvey O. Coxson; Edwin K. Silverman; Amund Gulsvik; Per Bakke
RATIONALE Low educational attainment is a risk factor of chronic obstructive pulmonary disease (COPD). There is limited knowledge on the relationship between educational level and computed tomography measures of emphysema and airway wall thickness (AWT). OBJECTIVES We hypothesized that low educational attainment is associated with increased emphysema and AWT in ever-smokers with and without COPD. METHODS We included 462 and 485 ever-smokers with and without COPD in a cross-sectional study, aged 40-86 years. The sample was divided into groups reflecting educational attainment: primary, secondary, and university. We performed linear regression to examine associations between educational attainment and both emphysema and AWT separately for those with and without COPD. We adjusted for sex, age, smoking status, age of onset of smoking, pack-years, height, and body mass index. MEASUREMENTS AND MAIN RESULTS Compared with university education, in subjects with COPD, primary education was associated with a 68.1% (95% confidence interval = 14.2-147.6%; P = 0.01) relative increase in emphysema and secondary education was associated with a 50.6% (95% confidence interval = 5.7-114.6%; P = 0.02) relative increase. There was a nonsignificant trend toward an association between lower educational attainment and increased emphysema among those without COPD (P = 0.18), yet greater age appeared to modify this association (P = 0.01). We did not detect significant linear relationships between educational attainment and AWT in subjects with or without COPD. CONCLUSIONS Lower educational attainment was associated with increased emphysema among adults with COPD. Among those without COPD, this association was more pronounced with increasing age. No significant linear relationship between educational attainment and AWT was found. Clinicians treating adults with emphysema should keep in mind that factors related to low education beyond that of smoking and occupational dust exposure might be of importance to the disease.
Respiratory Medicine | 2016
Tomas Ml Eagan; Jon A. Hardie; Åsne Jul-Larsen; Thomas Grydeland; Per Bakke; Rebecca Jane Cox
BACKGROUND COPD patients are advised vaccination against seasonal influenza, yet few studies have evaluated the protective antibody titers obtained in this patient group. AIMS 1) To describe protective titers in COPD patients who self-reported influenza vaccination compared with vaccinated subjects without COPD and unvaccinated COPD patients, 2) analyze whether clinical parameters predicted influenza-specific antibody titers, and 3) whether antibody titers to influenza A at baseline could predict exacerbation risk or 5 years all-cause mortality. METHODS Influenza A (H1N1 and H3N2) titers were measured by haemagglutination inhibition assay in serum from 432 COPD patients and 77 controls in the Bergen COPD Cohort Study, at yearly visits between 2006/09. Titers of 40 or above were considered protective. We examined the variables sex, age, body composition, smoking, GOLD stage, yearly exacerbations, inhaled steroids, and Charlson score as predictive of titers, both univariately and in a multivariable model estimated by generalized estimating equations. The exacerbation incidence rate ratios and mortality hazard ratios were assessed by negative binominal and cox regression models respectively. RESULTS At baseline, 59% of COPD patients reported influenza vaccination during the last season. Levels of predictive titers varied considerably each season, but trended lower in COPD patients compared with controls. Neither sex, age, body composition, smoking, comorbidities, GOLD stage nor use of inhaled steroids consistently predicted titers. Having high titers at baseline did not impact later risk for exacerbations, but seemed to be associated with higher all-cause mortality, even after adjustment for COPD disease characteristics. CONCLUSION Vaccination coverage for influenza is imperfect for COPD patients in Norway, and there is a concern that immunization is suboptimal.
Respiratory Medicine | 2011
Thomas Grydeland; Einar Thorsen; Asger Dirksen; Robert L. Jensen; Harvey O. Coxson; Sreekumar G. Pillai; Sanjay Sharma; Geir Egil Eide; Amund Gulsvik; Per Bakke