Abstract
It has been suggested that the presence of emphysema alters physiology and survival in patients with idiopathic pulmonary fibrosis (IPF).
A cohort of 56 IPF patients was evaluated (32 men; mean age 62±10 yrs; 31 smokers). High-resolution CT scans were examined by experienced radiologist blinded to clinical data. The amount of emphysema (numerical score) were assessed in each patient, and cases were placed into one of three groups: no emphysema - emphysema score of zero (ES=0), mild emphysema (0<ES≤2), and advanced emphysema (ES>2). Clinical characteristics, smoking history, pulmonary function test (PFT) and patients survival were analysed.
Results: There were 31 IPF patients without emphysema, 11 with mild and 14 with advanced emphysema. Studied groups did not differ significantly with regard to smoking history, right ventricular systolic pressure (RVSP), PFT and 6-minute walk test findings. Patients with IPF associated with mild and advanced emphysema more frequently were men compared to patients with IPF without emphysema (82% and 71% vs 42%, respectively, p=0,03). Median follow-up [1st, 3rd quartiles] was 30 [14, 52] months and 16 patients died in this period (3 due to lung cancer, 12 due to IPF). Patients who died had lower mean VC (76 vs 89% pred., p=0.02), TLC (72 vs 81% pred., p=0,04), DLCO (36 vs 48% pred., p=0.005) and higher RVSP (51 vs 41 mmHg, p=0.03). Median survival of IPF patients with mild and advanced emphysema did not differ significantly compared to IPF patients without emphysematous changes (26, 31 and 30 months, respectively; p=0,14).
Conclusion: Emphysema associated with IPF does not affect the mortality rate compared to IPF alone.
- © 2013 ERS