Comorbidity burden and survival in patients with idiopathic pulmonary fibrosis: the EMPIRE registry study.
EMPIRE
Idiopathic pulmonary fibrosis
Mortality
Registry
Journal
Respiratory research
ISSN: 1465-993X
Titre abrégé: Respir Res
Pays: England
ID NLM: 101090633
Informations de publication
Date de publication:
27 May 2022
27 May 2022
Historique:
received:
22
11
2021
accepted:
24
04
2022
entrez:
27
5
2022
pubmed:
28
5
2022
medline:
1
6
2022
Statut:
epublish
Résumé
Patients with idiopathic pulmonary fibrosis (IPF) frequently have multiple comorbidities, which may influence survival but go under-recognised in clinical practice. We therefore report comorbidity, antifibrotic treatment use and survival of patients with IPF observed in the multi-national EMPIRE registry. For this prospective IPF cohort, demographics, comorbidities, survival and causes of death were analysed. Comorbidities were noted by the treating physician based on the patient's past medical history or as reported during follow-up. Comorbidities were defined as prevalent when noted at enrolment, or as incident when recorded during follow-up. Survival was analysed by Kaplan-Meier estimates, log-rank test, and Cox proportional hazards models. Hazard ratios (HR) were adjusted for gender, age, smoking status and FVC at enrolment. A population of 3,580 patients with IPF from 11 Central and Eastern European countries was followed every 6 months for up to 6 years. At enrolment, 91.3% of patients reported at least one comorbidity, whereas more than one-third (37.8%) reported four or more comorbidities. Five-year survival was 53.7% in patients with no prevalent comorbidities, whereas it was 48.4%, 47.0%, 43.8% and 41.1% in patients with 1, 2, 3 and ≥ 4 comorbidities, respectively. The presence of multiple comorbidities at enrolment was associated with significantly worse survival (log-rank test P = 0.007). Adjusted HRs indicate that risk of death was increased by 44% in patients with IPF reporting ≥ 4 comorbidities at baseline compared with no comorbidity (P = 0.021). The relationship between number of comorbidities and decreased survival was also seen in patients receiving antifibrotic treatment (63% of all patients; log-rank test P < 0.001). Comorbidity as cause of death was identified in at least 26.1% of deaths. The majority of patients with IPF demonstrate comorbidities, and many have comorbidity-related deaths. Increasing numbers of comorbidities are associated with worse survival; and this pattern is also present in patients receiving antifibrotic therapy.
Sections du résumé
BACKGROUND
BACKGROUND
Patients with idiopathic pulmonary fibrosis (IPF) frequently have multiple comorbidities, which may influence survival but go under-recognised in clinical practice. We therefore report comorbidity, antifibrotic treatment use and survival of patients with IPF observed in the multi-national EMPIRE registry.
METHODS
METHODS
For this prospective IPF cohort, demographics, comorbidities, survival and causes of death were analysed. Comorbidities were noted by the treating physician based on the patient's past medical history or as reported during follow-up. Comorbidities were defined as prevalent when noted at enrolment, or as incident when recorded during follow-up. Survival was analysed by Kaplan-Meier estimates, log-rank test, and Cox proportional hazards models. Hazard ratios (HR) were adjusted for gender, age, smoking status and FVC at enrolment.
RESULTS
RESULTS
A population of 3,580 patients with IPF from 11 Central and Eastern European countries was followed every 6 months for up to 6 years. At enrolment, 91.3% of patients reported at least one comorbidity, whereas more than one-third (37.8%) reported four or more comorbidities. Five-year survival was 53.7% in patients with no prevalent comorbidities, whereas it was 48.4%, 47.0%, 43.8% and 41.1% in patients with 1, 2, 3 and ≥ 4 comorbidities, respectively. The presence of multiple comorbidities at enrolment was associated with significantly worse survival (log-rank test P = 0.007). Adjusted HRs indicate that risk of death was increased by 44% in patients with IPF reporting ≥ 4 comorbidities at baseline compared with no comorbidity (P = 0.021). The relationship between number of comorbidities and decreased survival was also seen in patients receiving antifibrotic treatment (63% of all patients; log-rank test P < 0.001). Comorbidity as cause of death was identified in at least 26.1% of deaths.
CONCLUSIONS
CONCLUSIONS
The majority of patients with IPF demonstrate comorbidities, and many have comorbidity-related deaths. Increasing numbers of comorbidities are associated with worse survival; and this pattern is also present in patients receiving antifibrotic therapy.
Identifiants
pubmed: 35624513
doi: 10.1186/s12931-022-02033-6
pii: 10.1186/s12931-022-02033-6
pmc: PMC9145164
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
135Investigateurs
Stefan Zembacher
(S)
Michael Studnicka
(M)
David Lang
(D)
Bernd Lamprecht
(B)
Natalia Stoeva
(N)
Suzana Mladinov
(S)
Dino Ilak
(D)
Mirna Vergles
(M)
Neven Tudorić
(N)
Jasna Tekavec-Trkanjec
(J)
Martina Vašáková
(M)
Martina Šterclová
(M)
None Jiří
Ladislav Lacina
(L)
Pavlína Lisá
(P)
Radka Bittenglová
(R)
Vladimír Bartoš
(V)
None Renata
Vladimíra Lošťáková
(V)
Monika Žurková
(M)
Jana Pšíkalová
(J)
Ilona Binková
(I)
Martina Doubková
(M)
Jan Kervitzer
(J)
Tomáš Snížek
(T)
Pavel Reiterer
(P)
Hana Šuldová
(H)
Martina Plačková
(M)
Richard Tyl
(R)
Vladimír Řihák
(V)
Ladislav Dušek
(L)
Karel Hejduk
(K)
Jakub Gregor
(J)
Ondřej Májek
(O)
Simona Littnerová
(S)
Michal Svoboda
(M)
Miklós Zsiray
(M)
Veronika Müller
(V)
Anikó Bohács
(A)
Maria Szilasi
(M)
Zsuzsanna Szalai
(Z)
Zoltán Balikó
(Z)
Attila Somfay
(A)
Imre Lajkó
(I)
Mordechai Kramer
(M)
Yochai Adir
(Y)
Biserka Jovkovska Kjaeva
(BJ)
Ewa Jassem
(E)
Alicja Sieminska
(A)
Amelia Szymanowska-Narloch
(A)
Adam Barczyk
(A)
Krzysztof Sladek
(K)
Aleksander Kania
(A)
Lukasz Kasper
(L)
Tomasz Stachura
(T)
Paulina Jurek
(P)
Sebastian Majewski
(S)
Agata Nowicka
(A)
Lukasz Borucki
(L)
Katarzyna Lewandowska
(K)
Małgorzata Sobiecka
(M)
Beate Zolnowska
(B)
Pawel Sliwinski
(P)
Damian Korzybski
(D)
Magdalena Martusewicz-Boros
(M)
Elzbieta Wiatr
(E)
Marta Maskey-Warzęchowska
(M)
Katarzyna Górska
(K)
Małgorzata Barnaś
(M)
Violeta Vučinić-Mihailović
(V)
Branislava Milenković
(B)
Milica Kontić
(M)
Natalija Samardžić
(N)
Marina Roksandić
(M)
Dragana Jovanovic
(D)
Tatjana Pejcic
(T)
Desa Nastasijevic Boravac
(DN)
Emilija Videnovic
(E)
Tatjana Radjenovic Petkovic
(TR)
Ivanka Djordejevic
(I)
Svetlana Kašiković Lečić
(SK)
Vesna Kuruc
(V)
Živka Eri
(Ž)
Milana Panjković
(M)
Aleksandra Lovrenski
(A)
Darinka Kukavica
(D)
Ana Jakić
(A)
Slavica Mojsilovic
(S)
Marta Hájková
(M)
Štefan Laššán
(Š)
Štefan Tóth
(Š)
Ján Plutinský
(J)
Róbert Vyšehradský
(R)
Bohumil Matula
(B)
Róbert Slivka
(R)
Imrich Jonner
(I)
Nesrin Mogulkoc
(N)
Informations de copyright
© 2022. The Author(s).
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