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

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,...

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Autores: 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
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/212244
Acceso en línea:https://hdl.handle.net/2445/212244
Access Level:acceso abierto
Palabra clave:Malalties del pulmó
Malalties immunitàries
Pulmonary diseases
Immunologic diseases
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spelling Prognostic factors of progressive fibrotic hypersensitivity pneumonitis: a large, retrospective, multicentre, observational cohort studyCano Jiménez, Esteban AlbertoVillar Gómez, AnaVélez Segovia, EduardoAburto Barrenechea, MyriamSellarés Torres, JacoboFrancesqui, JoelPortillo Carroz, KarinaSolis Solis, Alan JhuniorAcosta Fernández, OrlandoLlanos González, Ana BelénBordas Martínez, JaumeCabrera César, EvaBalcells Vilarnau, EvaCastillo Villegas, DiegoReyes Pardessus, AnaGonzález Fernández, CoralGarcía Moyano, MartaUrrutia Gajate, AmaiaBlanco Hortas, AndrésMolina Molina, MaríaMalalties del pulmóMalalties immunitàriesPulmonary diseasesImmunologic diseasesFibrotic 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.European Respiratory Society (ERS)2024202420242024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion11 p.application/pdfhttps://hdl.handle.net/2445/212244Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1183/23120541.00405-2023ERJ Open Research, 2024, vol. 10, num. 1https://doi.org/10.1183/23120541.00405-2023cc by-nc (c) Cano Jiménez, Esteban et al, 2024http://creativecommons.org/licenses/by-nc/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/2122442026-05-29T05:05:01Z
dc.title.none.fl_str_mv Prognostic factors of progressive fibrotic hypersensitivity pneumonitis: a large, retrospective, multicentre, observational cohort study
title Prognostic factors of progressive fibrotic hypersensitivity pneumonitis: a large, retrospective, multicentre, observational cohort study
spellingShingle Prognostic factors of progressive fibrotic hypersensitivity pneumonitis: a large, retrospective, multicentre, observational cohort study
Cano Jiménez, Esteban Alberto
Malalties del pulmó
Malalties immunitàries
Pulmonary diseases
Immunologic diseases
title_short Prognostic factors of progressive fibrotic hypersensitivity pneumonitis: a large, retrospective, multicentre, observational cohort study
title_full Prognostic factors of progressive fibrotic hypersensitivity pneumonitis: a large, retrospective, multicentre, observational cohort study
title_fullStr Prognostic factors of progressive fibrotic hypersensitivity pneumonitis: a large, retrospective, multicentre, observational cohort study
title_full_unstemmed Prognostic factors of progressive fibrotic hypersensitivity pneumonitis: a large, retrospective, multicentre, observational cohort study
title_sort Prognostic factors of progressive fibrotic hypersensitivity pneumonitis: a large, retrospective, multicentre, observational cohort study
dc.creator.none.fl_str_mv 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
author Cano Jiménez, Esteban Alberto
author_facet 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
author_role author
author2 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
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Malalties del pulmó
Malalties immunitàries
Pulmonary diseases
Immunologic diseases
topic Malalties del pulmó
Malalties immunitàries
Pulmonary diseases
Immunologic diseases
description 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.
publishDate 2024
dc.date.none.fl_str_mv 2024
2024
2024
2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/212244
url https://hdl.handle.net/2445/212244
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1183/23120541.00405-2023
ERJ Open Research, 2024, vol. 10, num. 1
https://doi.org/10.1183/23120541.00405-2023
dc.rights.none.fl_str_mv cc by-nc (c) Cano Jiménez, Esteban et al, 2024
http://creativecommons.org/licenses/by-nc/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by-nc (c) Cano Jiménez, Esteban et al, 2024
http://creativecommons.org/licenses/by-nc/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 11 p.
application/pdf
dc.publisher.none.fl_str_mv European Respiratory Society (ERS)
publisher.none.fl_str_mv European Respiratory Society (ERS)
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812429

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