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oai:recercat.cat:10230/613792025-12-18T01:09:39Zcom_2072_6col_2072_452952

Prognostic factors of progressive fibrotic hypersensitivity pneumonitis: a large, retrospective, multicentre, observational cohort study Cano Jiménez, Esteban Villar Gómez, Ana Velez Segovia, Eduardo Aburto Barrenechea, Myriam Sellarés, Jacobo Francesqui, Joel Portillo, Karina Solis Solis, Alan Jhunior Acosta Fernández, Orlando Llanos González, Ana Belén Bordas Martínez, Jaume Cabrera César, Eva Balcells Vilarnau, Eva, 1967- Castillo, Diego Reyes Pardessus, Ana González Fernández, Coral García Moyano, Marta Urrutia Gajate, Amaia Blanco Hortas, Andrés Molina-Molina, María Pneumonitis per hipersensibilitat Background: Fibrotic hypersensitivity pneumonitis (fHP) is an immune-mediated interstitial lung disease caused by sensitisation to chronic allergen inhalation. This study aimed to determine prognostic indicators of progression and mortality in fHP. Methods: This was a retrospective, multicentre, observational, cross-sectional cohort study of consecutive patients diagnosed with fHP from 1 January 2012 to 31 December 2021. Multivariate Cox regression analyses were used to calculate hazard ratios (HRs) with 95% confidence intervals for predictors of progression and survival. Results: A total of 403 patients were diagnosed with fHP: median (interquartile range) age 66.5 (14.0) years, 51.9% females and 55.1% never-smokers. The cause of fHP was mainly fungal (39.7%) or avian (41.4%). Lung biopsy was performed in 269 cases (66.7%). In the whole cohort the variables that were related to mortality or lung transplant were older age (HR 1.08; p<0.001), percentage predicted forced vital capacity (HR 0.96; p=0.001), lymphocytosis in bronchoalveolar lavage (BAL) (HR 0.93; p=0.001), presence of acute exacerbation during follow-up (HR 3.04; p=0.001) and GAP (gender, age and lung physiology) index (HR 1.96; p<0.01). In the group of biopsied patients, the presence of fibroblastic foci at biopsy (HR 8.39; p<0.001) stands out in multivariate Cox regression analyses as a highly significant predictor for increased mortality or lung transplant. GAP index (HR 1.26; p=0.009), lymphocytosis in BAL (HR 0.97; p=0.018) and age (HR 1.03; p=0.018) are also predictors of progression. Conclusions: The study identified several prognostic factors for progression and/or survival in fHP. The presence of fibroblastic foci at biopsy was a consistent predictor for increased mortality and the presence of lymphocytosis in BAL was inversely related to mortality. 2024-10-14T06:28:01Z 2024-10-14T06:28:01Z 2024 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Cano-Jiménez E, Villar Gómez A, Velez Segovia E, Aburto Barrenechea M, Sellarés Torres J, Francesqui J, et al. Prognostic factors of progressive fibrotic hypersensitivity pneumonitis: a large, retrospective, multicentre, observational cohort study. ERJ Open Res. 2024 Feb 26;10(1):00405-2023. DOI: 10.1183/23120541.00405-2023 2312-0541 http://hdl.handle.net/10230/61379 http://dx.doi.org/10.1183/23120541.00405-2023 eng ERJ Open Res. 2024 Feb 26;10(1):00405-2023 Copyright © The authors 2024. This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0 (http://creativecommons.org/licenses/by-nc/4.0/). For commercial reproduction rights and permissions contact permissions@ersnet.org http://creativecommons.org/licenses/by-nc/4.0/ info:eu-repo/semantics/openAccess application/pdf application/pdf European Respiratory Society