Pneumothorax in connective tissue disease-associated interstitial lung disease.
Aged
Anti-Inflammatory Agents
/ therapeutic use
Connective Tissue Diseases
/ complications
Female
Humans
Incidence
Kaplan-Meier Estimate
Lung Diseases, Interstitial
/ complications
Male
Methylprednisolone
/ therapeutic use
Middle Aged
Pneumothorax
/ complications
Prognosis
Proportional Hazards Models
Respiratory Function Tests
Retrospective Studies
Risk Factors
Tomography, X-Ray Computed
Treatment Outcome
Vital Capacity
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
06
04
2020
accepted:
18
06
2020
entrez:
8
7
2020
pubmed:
8
7
2020
medline:
17
9
2020
Statut:
epublish
Résumé
Spontaneous pneumothorax is a complication that occurs in patients with connective tissue disease-associated interstitial lung disease (CTD-ILD); however, few studies on the clinical implications of pneumothorax for patients with CTD-ILD have been performed. This study aimed to investigate the incidence and prognostic significance of pneumothorax and the risk factors for its onset in patients with CTD-ILD. This study included 140 consecutive patients with CTD-ILD. Clinical characteristics, laboratory findings, pulmonary function test results, and chest high-resolution computed tomography (HRCT) images were retrospectively evaluated. A total of 18 patients (12.9%) developed pneumothorax during their clinical course. The cumulative incidence of pneumothorax from the time of CTD-ILD diagnosis was 6.5%, 8.7%, and 11.3% at 1, 3, and 5 years, respectively. The 10-year survival rate was significantly lower in patients with pneumothorax (29.6%) than that in those without pneumothorax (81.3%). The development of pneumothorax was significantly associated with poor prognosis (HR 22.0; p < 0.010). Furthermore, a lower body mass index, greater extent of reticular abnormalities on HRCT, and administration of methylprednisolone pulse therapy were significantly associated with the development of pneumothorax. Pneumothorax is a serious complication in the clinical course of patients with CTD-ILD and the onset of pneumothorax predicts a poor outcome.
Sections du résumé
BACKGROUND
Spontaneous pneumothorax is a complication that occurs in patients with connective tissue disease-associated interstitial lung disease (CTD-ILD); however, few studies on the clinical implications of pneumothorax for patients with CTD-ILD have been performed.
OBJECTIVES
This study aimed to investigate the incidence and prognostic significance of pneumothorax and the risk factors for its onset in patients with CTD-ILD.
METHODS
This study included 140 consecutive patients with CTD-ILD. Clinical characteristics, laboratory findings, pulmonary function test results, and chest high-resolution computed tomography (HRCT) images were retrospectively evaluated.
RESULTS
A total of 18 patients (12.9%) developed pneumothorax during their clinical course. The cumulative incidence of pneumothorax from the time of CTD-ILD diagnosis was 6.5%, 8.7%, and 11.3% at 1, 3, and 5 years, respectively. The 10-year survival rate was significantly lower in patients with pneumothorax (29.6%) than that in those without pneumothorax (81.3%). The development of pneumothorax was significantly associated with poor prognosis (HR 22.0; p < 0.010). Furthermore, a lower body mass index, greater extent of reticular abnormalities on HRCT, and administration of methylprednisolone pulse therapy were significantly associated with the development of pneumothorax.
CONCLUSION
Pneumothorax is a serious complication in the clinical course of patients with CTD-ILD and the onset of pneumothorax predicts a poor outcome.
Identifiants
pubmed: 32634173
doi: 10.1371/journal.pone.0235624
pii: PONE-D-20-09813
pmc: PMC7340294
doi:
Substances chimiques
Anti-Inflammatory Agents
0
Methylprednisolone
X4W7ZR7023
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0235624Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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