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00405-2023.pdf (678.97 KB)

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2024-01-01

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cc by-nc (c) Cano Jiménez, Esteban et al, 2024
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/212244

Prognostic factors of progressive fibrotic hypersensitivity pneumonitis: a large, retrospective, multicentre, observational cohort study

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https://doi.org/10.1183/23120541.00405-2023

Resum

Fibrotic hypersensitivity pneumonitis ( fHP) is an immune-mediated interstitial lung disease caused by sensitisation to chronic allergen inhalation. This study aimed to determine prognostic indicators of progression and mortality in fHP. Methods This was a retrospective, multicentre, observational, cross-sectional cohort study of consecutive patients diagnosed with fHP from 1 January 2012 to 31 December 2021. Multivariate Cox regression analyses were used to calculate hazard ratios (HRs) with 95% confidence intervals for predictors of progression and survival. Results A total of 403 patients were diagnosed with fHP: median (interquartile range) age 66.5 (14.0) years, 51.9% females and 55.1% never-smokers. The cause of fHP was mainly fungal (39.7%) or avian (41.4%). Lung biopsy was performed in 269 cases (66.7%). In the whole cohort the variables that were related to mortality or lung transplant were older age (HR 1.08; p<0.001), percentage predicted forced vital capacity (HR 0.96; p=0.001), lymphocytosis in bronchoalveolar lavage (BAL) (HR 0.93; p=0.001), presence of acute exacerbation during follow-up (HR 3.04; p=0.001) and GAP (gender, age and lung physiology) index (HR 1.96; p<0.01). In the group of biopsied patients, the presence of fibroblastic foci at biopsy (HR 8.39; p<0.001) stands out in multivariate Cox regression analyses as a highly significant predictor for increased mortality or lung transplant. GAP index (HR 1.26; p=0.009), lymphocytosis in BAL (HR 0.97; p=0.018) and age (HR 1.03; p=0.018) are also predictors of progression. Conclusions The study identified several prognostic factors for progression and/or survival in fHP. The presence of fibroblastic foci at biopsy was a consistent predictor for increased mortality and the presence of lymphocytosis in BAL was inversely related to mortality.

Matèries

Malalties del pulmó, Malalties immunitàries

Matèries (anglès)

Pulmonary diseases, Immunologic diseases

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Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Citació

CANO JIMÉNEZ, Esteban alberto, VILLAR GÓMEZ, Ana, VÉLEZ SEGOVIA, Eduardo, ABURTO BARRENECHEA, Myriam, SELLARÉS TORRES, Jacobo, FRANCESQUI, Joel, PORTILLO CARROZ, Karina, SOLIS SOLIS, Alan jhunior, ACOSTA FERNÁNDEZ, Orlando, LLANOS GONZÁLEZ, Ana belén, BORDAS MARTÍNEZ, Jaume, CABRERA CÉSAR, Eva, BALCELLS VILARNAU, Eva, CASTILLO VILLEGAS, Diego, REYES PARDESSUS, Ana, GONZÁLEZ FERNÁNDEZ, Coral, GARCÍA MOYANO, Marta, URRUTIA GAJATE, Amaia, BLANCO HORTAS, Andrés, MOLINA MOLINA, María. Prognostic factors of progressive fibrotic hypersensitivity pneumonitis: a large, retrospective, multicentre, observational cohort study. _ERJ Open Research_. 2024. Vol. 10, núm. 1. [consulta: 23 de gener de 2026]. ISSN: 2312-0541. [Disponible a: https://hdl.handle.net/2445/212244]

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