2026-04-17T09:49:06Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/111532025-10-24T10:27:00Zcom_2072_378070com_2072_378040col_2072_378092

2025-10-24T10:27:00Z urn:hdl:11351/11153 Prognostic factors of progressive fibrotic hypersensitivity pneumonitis: a large, retrospective, multicentre, observational cohort study Cano-Jiménez, Esteban Vélez-Segovia, Eduardo Aburto, Myriam Sellarés, Jacobo Francesqui, Joel Villar, Ana Pneumonitis per hipersensibilitat - Prognosi Fibrosi pulmonar - Prognosi DISEASES::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Interstitial::Alveolitis, Extrinsic Allergic DISEASES::Respiratory Tract Diseases::Lung Diseases::Pulmonary Fibrosis ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis ENFERMEDADES::enfermedades respiratorias::enfermedades pulmonares::enfermedades pulmonares intersticiales::alveolitis alérgica extrínseca ENFERMEDADES::enfermedades respiratorias::enfermedades pulmonares::fibrosis pulmonar TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico Factors pronòstics; Pneumonitis; Hipersensibilitat fibròtica progressiva Factores pronósticos; Neumonitis; Hipersensibilidad fibrótica progresiva Prognostic factors; Pneumonitis; Progressive fibrotic hypersensitivity 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. 2025-10-24T10:27:00Z 2025-10-24T10:27:00Z 2024-03-04T12:10:58Z 2024-03-04T12:10:58Z 2024-01-14 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/11153 ERJ Open Research;10(1) http://www.doi.org/10.1183/23120541.00405-2023 Attribution-NonCommercial 4.0 International http://creativecommons.org/licenses/by-nc/4.0/ info:eu-repo/semantics/openAccess European Respiratory Society Scientia