Prognostic factors of progressive fibrotic hypersensitivity pneumonitis : a large, retrospective, multicentre, observational cohort study
Cano-Jiménez, Esteban (Hospital Universitario Lucus Augusti (Lugo))
Villar Gómez, Ana (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Vélez-Segovia, Eduardo (Hospital Universitari Vall d'Hebron)
Aburto, Myriam (Hospital Universitario Galdakao)
Serallés Torres, Jacobo (Hospital Clínic i Provincial de Barcelona)
Francesqui, Joel (Hospital Clínic i Provincial de Barcelona)
Portillo, Karina (Institut Germans Trias i Pujol)
Solis Solis, Alan Jhunior (Institut Germans Trias i Pujol)
Acosta Fernández, Orlando (Complejo Hospitalario Universitario de Canarias)
Llanos González, Ana Belén (Complejo Hospitalario Universitario de Canarias)
Bordas-Martinez, Jaume (Hospital Universitari de Bellvitge)
Cabrera César, Eva (Hospital Universitario Virgen de la Victoria (Màlaga, Andalusia))
Balcells, Eva (Hospital del Mar (Barcelona, Catalunya))
Castillo, Diego (Institut de Recerca Sant Pau)
Reyes Pardessus, Ana (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
González Fernández, Coral (Complexo Hospitalario Universitario de Ourense - CHUO)
García Moyano, Marta (Hospital Universitario de Cruces (Barakaldo, País Basc))
Urrutia Gajate, Amaia (Hospital Universitario de Cruces (Barakaldo, País Basc))
Blanco Hortas, Andrés (Hospital Universitario Lucus Augusti (Lugo))
Molina Molina, Maria (Hospital Universitari de Bellvitge)

Fecha:	2024
Resumen:	Background 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.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	ERJ Open Research, Vol. 10 Núm. 1 (january 2024) , p. 405-2023, ISSN 2312-0541

DOI: 10.1183/23120541.00405-2023
PMID: 38410707

11 p, 678.0 KB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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