Clusters of comorbidities in fibrotic hypersensitivity pneumonitis

Respiratory Research

Research

Michael Kreuter¹  Benjamin Gross¹  Julia Wälscher²  Elisabeth Bendstrup³  Thomas Skovhus Prior³ 

[1] Centre for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany;German Center for Lung Research (DZL), Heidelberg, Germany;Centre for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany;German Center for Lung Research (DZL), Heidelberg, Germany;Centre for Interstitial and Rare Lung Diseases, Pneumology Department, Ruhrlandklinik, University Hospital, University of Essen, Essen, Germany;Centre for Rare Lung Diseases, Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark;Department of Clinical Medicine, Aarhus University, Aarhus, Denmark;

关键词: Comorbidity;    Hypersensitivity pneumonitis;    Allergic alveolitis;    Cluster analyses;    Interstitial lung disease;    Pulmonary fibrosis;    Respiratory tract diseases;   

DOI  :  10.1186/s12931-022-02291-4

 received in 2022-06-17, accepted in 2022-12-13,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundHypersensitivity pneumonitis (HP) is a type of interstitial lung disease (ILD) with a variable disease course and prognosis ranging from inflammatory and self-limiting to irreversible and progressive pulmonary fibrosis. Comorbidities are common in HP and may have an impact on prognosis. Due to the heterogeneity of HP presentation and progression, the identification of specific phenotypes in relationship to disease course and outcome is essential. The aim of this study was to identify clusters of comorbidities which could represent phenotypes in fibrotic HP and examine their impact on prognosis.MethodsPatients diagnosed with fibrotic HP at a tertiary referral center for ILD were included. Comorbidities were systematically registered and clusters of comorbidities were identified using cluster analyses. Disease progression and survival was estimated for each cluster.ResultsThe cohort comprised 211 patients with 53.6% males, mean age 63.0, baseline FVC 72.7%, DLCO 44.1%. Median follow-up time was 1.8 years (IQR 0.7–3.9). Three clusters with distinct comorbidity profiles and clinical characteristics were identified. One cluster dominated by elder male patients with predominantly cardiovascular diseases was associated with more respiratory hospitalizations and a worse prognosis. Differences in pulmonary function or exercise capacity trajectories between clusters were not observed.ConclusionsThree clusters with distinct comorbidities were identified and could represent phenotypes in fibrotic HP not previously recognized. The worst prognosis was observed in a cluster dominated by elder males with cardiovascular diseases. Increased focus on prevention and treatment of comorbidities could potentially improve the prognosis of patients with fibrotic HP.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

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