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PLoS One. 2016 Mar 29;11(3):e0151425. doi: 10.1371/journal.pone.0151425. eCollection 2016.

Impact of Comorbidities on Mortality in Patients with Idiopathic Pulmonary Fibrosis.

Author information

1
Centre for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
2
Member of the German Center for Lung Research, Translational Lung Research Centre, Heidelberg, Germany.
3
ECSOR Department of Biostatistics, Gembloux, Belgium.
4
Department of Translational Research, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
5
Diagnostic and Interventional Radiology, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
6
Department of Radiology, University of Heidelberg, Heidelberg, Germany.
7
Institute of Pathology, University of Heidelberg, Heidelberg, Germany.
8
McMaster University, Hamilton, ON, Canada.

Abstract

INTRODUCTION:

Comorbidities significantly influence the clinical course of idiopathic pulmonary fibrosis (IPF). However, their prognostic impact is not fully understood. We therefore aimed to determine the impact of comorbidities, as individual and as whole, on survival in IPF.

METHODS:

The database of a tertiary referral centre for interstitial lung diseases was reviewed for comorbidities, their treatments, their frequency and survival in IPF patients.

RESULTS:

272 patients were identified of which 12% had no, 58% 1-3 and 30% 4-7 comorbidities, mainly cardiovascular, pulmonary and oncologic comorbidities. Median survival according to the frequency of comorbidities differed significantly with 66 months for patients without comorbidities, 48 months when 1-3 comorbidities were reported and 35 months when 4-7 comorbidities were prevalent (p = 0.004). A multivariate Cox proportional hazard analyses identified other cardiac diseases and lung cancer as significant predictors of death, gastro-oesophageal reflux disease (GERD) and diastolic dysfunction had a significant positive impact on survival. A significant impact of comorbidities associated therapies on survival was not discovered. This included the use of proton pump inhibitors at baseline, which was not associated with a survival benefit (p = 0.718). We also established a predictive tool for highly prevalent comorbidities, termed IPF comorbidome which demonstrates a new relationship of IPF and comorbidities.

CONCLUSION:

Comorbidities are frequent in IPF patients. Some comorbidities, especially lung cancer, mainly influence survival in IPF, while others such as GERD may inherit a more favourable effect. Moreover, their cumulative incidence impacts survival.

PMID:
27023440
PMCID:
PMC4811578
DOI:
10.1371/journal.pone.0151425
[Indexed for MEDLINE]
Free PMC Article
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