The impact of combined pulmonary fibrosis and emphysema on mortality
Abstract:SETTING: The impact on patient mortality of combined pulmonary fibrosis and emphysema (CPFE) compared with emphysema alone has never been investigated.
OBJECTIVE: To elucidate whether CPFE has an impact on overall mortality over that of emphysema alone.
DESIGN: We screened patients who underwent chest computed tomography (CT) scans during the period from 1 January 2001 to 31 December 2005 in a tertiary referral hospital. Patients who had both emphysema and pulmonary fibrosis, thus meeting the inclusion criteria, were defined as CPFE. Controls with emphysema alone who were matched for age, sex and the date of CT scan were randomly selected. Cox proportional regression analysis was performed to verify whether CPFE is associated with increased overall mortality.
RESULTS: We found 135 CPFE cases. In the multivariable Cox regression stratified by the presence of comorbid malignancy, CPFE had five times higher mortality risk (adjusted HR 5.10, 95%CI 1.75–14.9) in non-malignant cases, and showed a statistically insignificant trend for higher mortality risk (adjusted HR 1.70, 95%CI 0.94–2.51) in the malignant cases after adjusting for forced vital capacity, height and hypertension.
CONCLUSION: CPFE is not rare and CPFE patients had a higher overall mortality risk than emphysema-only patients.
Document Type: Regular Paper
Affiliations: 1: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul Metropolitan Government, Seoul, Republic of Korea 2: Department of Respiratory Medicine, Konkuk University Hospital, Seoul, Republic of Korea 3: Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea 4: Center for Lung Cancer, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea 5: Division of Pulmonary and Critical Care Medicine and Lung Institute, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea 6: Department of Social and Preventive Medicine, School of Medicine, Inha University, Inchon, Republic of Korea
Publication date: August 1, 2011
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