The prognostic significance of pneumothorax in patients with idiopathic pulmonary fibrosis

Koji Nishimoto, Tomoyuki Fujisawa, Katsuhiro Yoshimura, Yasunori Enomoto, Noriyuki Enomoto, Yutaro Nakamura, Naoki Inui, Hiromitsu Sumikawa, Takeshi Johkoh, Thomas V. Colby, Takafumi Suda

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background and objective: Pneumothorax is a co-morbidity in patients with idiopathic pulmonary fibrosis (IPF). However, its incidence, risk factors and prognostic significance in IPF remain unclear. The aim of this study was to clarify the incidence and prognostic significance of pneumothorax in patients with IPF, and to further investigate the risk factors for its onset. Methods: Eighty-four consecutive patients with IPF based on the consensus guideline were included in this study. We retrospectively reviewed the medical records, pulmonary function tests and chest high-resolution computed tomography images, and determined the incidence of pneumothorax. The prognostic significance of pneumothorax was evaluated using the Cox proportional hazards model analysis with time-dependent covariates. We also assessed the cumulative incidence and the risk factors for pneumothorax. Results: Of the 84 patients, 17 (20.2%) developed pneumothorax. The cumulative incidence of pneumothorax was 8.5%, 12.5% and 17.7% at 1, 2 and 3years, respectively. Univariate analysis demonstrated that pneumothorax was significantly related to poor prognosis (hazards ratio, 2.99; P=0.002). Multivariate analysis, adjusting for sex, age and forced vital capacity (% predicted), revealed that pneumothorax was an independent predictor of poor outcome in IPF (hazards ratio, 2.85; P=0.006). Lower BMI and the presence of extensive reticular abnormalities were significantly associated with developing pneumothorax. Conclusion: These results confirm that patients with IPF often develop pneumothorax during their clinical course and that the onset of pneumothorax predicts a poor outcome.

Original languageEnglish (US)
JournalRespirology
DOIs
StateAccepted/In press - 2017

Fingerprint

Idiopathic Pulmonary Fibrosis
Pneumothorax
Incidence
Respiratory Function Tests
Vital Capacity
Proportional Hazards Models
Medical Records
Thorax
Multivariate Analysis

Keywords

  • Idiopathic pulmonary fibrosis
  • Incidence
  • Pneumothorax
  • Prognosis
  • Risk factors

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Nishimoto, K., Fujisawa, T., Yoshimura, K., Enomoto, Y., Enomoto, N., Nakamura, Y., ... Suda, T. (Accepted/In press). The prognostic significance of pneumothorax in patients with idiopathic pulmonary fibrosis. Respirology. https://doi.org/10.1111/resp.13219

The prognostic significance of pneumothorax in patients with idiopathic pulmonary fibrosis. / Nishimoto, Koji; Fujisawa, Tomoyuki; Yoshimura, Katsuhiro; Enomoto, Yasunori; Enomoto, Noriyuki; Nakamura, Yutaro; Inui, Naoki; Sumikawa, Hiromitsu; Johkoh, Takeshi; Colby, Thomas V.; Suda, Takafumi.

In: Respirology, 2017.

Research output: Contribution to journalArticle

Nishimoto, K, Fujisawa, T, Yoshimura, K, Enomoto, Y, Enomoto, N, Nakamura, Y, Inui, N, Sumikawa, H, Johkoh, T, Colby, TV & Suda, T 2017, 'The prognostic significance of pneumothorax in patients with idiopathic pulmonary fibrosis', Respirology. https://doi.org/10.1111/resp.13219
Nishimoto, Koji ; Fujisawa, Tomoyuki ; Yoshimura, Katsuhiro ; Enomoto, Yasunori ; Enomoto, Noriyuki ; Nakamura, Yutaro ; Inui, Naoki ; Sumikawa, Hiromitsu ; Johkoh, Takeshi ; Colby, Thomas V. ; Suda, Takafumi. / The prognostic significance of pneumothorax in patients with idiopathic pulmonary fibrosis. In: Respirology. 2017.
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abstract = "Background and objective: Pneumothorax is a co-morbidity in patients with idiopathic pulmonary fibrosis (IPF). However, its incidence, risk factors and prognostic significance in IPF remain unclear. The aim of this study was to clarify the incidence and prognostic significance of pneumothorax in patients with IPF, and to further investigate the risk factors for its onset. Methods: Eighty-four consecutive patients with IPF based on the consensus guideline were included in this study. We retrospectively reviewed the medical records, pulmonary function tests and chest high-resolution computed tomography images, and determined the incidence of pneumothorax. The prognostic significance of pneumothorax was evaluated using the Cox proportional hazards model analysis with time-dependent covariates. We also assessed the cumulative incidence and the risk factors for pneumothorax. Results: Of the 84 patients, 17 (20.2{\%}) developed pneumothorax. The cumulative incidence of pneumothorax was 8.5{\%}, 12.5{\%} and 17.7{\%} at 1, 2 and 3years, respectively. Univariate analysis demonstrated that pneumothorax was significantly related to poor prognosis (hazards ratio, 2.99; P=0.002). Multivariate analysis, adjusting for sex, age and forced vital capacity ({\%} predicted), revealed that pneumothorax was an independent predictor of poor outcome in IPF (hazards ratio, 2.85; P=0.006). Lower BMI and the presence of extensive reticular abnormalities were significantly associated with developing pneumothorax. Conclusion: These results confirm that patients with IPF often develop pneumothorax during their clinical course and that the onset of pneumothorax predicts a poor outcome.",
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T1 - The prognostic significance of pneumothorax in patients with idiopathic pulmonary fibrosis

AU - Nishimoto, Koji

AU - Fujisawa, Tomoyuki

AU - Yoshimura, Katsuhiro

AU - Enomoto, Yasunori

AU - Enomoto, Noriyuki

AU - Nakamura, Yutaro

AU - Inui, Naoki

AU - Sumikawa, Hiromitsu

AU - Johkoh, Takeshi

AU - Colby, Thomas V.

AU - Suda, Takafumi

PY - 2017

Y1 - 2017

N2 - Background and objective: Pneumothorax is a co-morbidity in patients with idiopathic pulmonary fibrosis (IPF). However, its incidence, risk factors and prognostic significance in IPF remain unclear. The aim of this study was to clarify the incidence and prognostic significance of pneumothorax in patients with IPF, and to further investigate the risk factors for its onset. Methods: Eighty-four consecutive patients with IPF based on the consensus guideline were included in this study. We retrospectively reviewed the medical records, pulmonary function tests and chest high-resolution computed tomography images, and determined the incidence of pneumothorax. The prognostic significance of pneumothorax was evaluated using the Cox proportional hazards model analysis with time-dependent covariates. We also assessed the cumulative incidence and the risk factors for pneumothorax. Results: Of the 84 patients, 17 (20.2%) developed pneumothorax. The cumulative incidence of pneumothorax was 8.5%, 12.5% and 17.7% at 1, 2 and 3years, respectively. Univariate analysis demonstrated that pneumothorax was significantly related to poor prognosis (hazards ratio, 2.99; P=0.002). Multivariate analysis, adjusting for sex, age and forced vital capacity (% predicted), revealed that pneumothorax was an independent predictor of poor outcome in IPF (hazards ratio, 2.85; P=0.006). Lower BMI and the presence of extensive reticular abnormalities were significantly associated with developing pneumothorax. Conclusion: These results confirm that patients with IPF often develop pneumothorax during their clinical course and that the onset of pneumothorax predicts a poor outcome.

AB - Background and objective: Pneumothorax is a co-morbidity in patients with idiopathic pulmonary fibrosis (IPF). However, its incidence, risk factors and prognostic significance in IPF remain unclear. The aim of this study was to clarify the incidence and prognostic significance of pneumothorax in patients with IPF, and to further investigate the risk factors for its onset. Methods: Eighty-four consecutive patients with IPF based on the consensus guideline were included in this study. We retrospectively reviewed the medical records, pulmonary function tests and chest high-resolution computed tomography images, and determined the incidence of pneumothorax. The prognostic significance of pneumothorax was evaluated using the Cox proportional hazards model analysis with time-dependent covariates. We also assessed the cumulative incidence and the risk factors for pneumothorax. Results: Of the 84 patients, 17 (20.2%) developed pneumothorax. The cumulative incidence of pneumothorax was 8.5%, 12.5% and 17.7% at 1, 2 and 3years, respectively. Univariate analysis demonstrated that pneumothorax was significantly related to poor prognosis (hazards ratio, 2.99; P=0.002). Multivariate analysis, adjusting for sex, age and forced vital capacity (% predicted), revealed that pneumothorax was an independent predictor of poor outcome in IPF (hazards ratio, 2.85; P=0.006). Lower BMI and the presence of extensive reticular abnormalities were significantly associated with developing pneumothorax. Conclusion: These results confirm that patients with IPF often develop pneumothorax during their clinical course and that the onset of pneumothorax predicts a poor outcome.

KW - Idiopathic pulmonary fibrosis

KW - Incidence

KW - Pneumothorax

KW - Prognosis

KW - Risk factors

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