Abstract
Introduction: Nocturnal desaturation may contribute to long-term pulmonary vascular stress in interstitial lung disease (ILD). We studied the prevalence and prognostic utility of nocturnal desaturation across ILDs.
Methods: ILD patients with overnight oximetry (January 2010-December 2013) were included (n=437; Idiopathic Pulmonary Fibrosis, n=122; Connective Tissue Disease-ILD, n=48; Hypersensitivity Pneumonitis, n=60; Non-specific Interstitial Pneumonia, n=56; unclassifiable, n=27; Sarcoidosis, n=66; other, n=58). Desaturation index (DI) was defined as the number of desaturation events >4%/hr.
Results: DI was higher in NSIP and CTD-ILD than in IPF (p=0.03 and p=0.02 respectively). In the whole cohort, DLco and serum BNP predicted mortality (HR 0.95; 95% CI 0.94, 0.96; p<0.0001 and HR 1.00; 95% CI 1.00, 1.00; p<0.0001). DI was not associated with mortality. In multivariate analysis, with adjustment for DLco and BNP, DI was associated with mortality a) in the whole cohort (HR 1.01; 95% CI 1.00, 1.03; p=0.015) and b) in non-IPF (HR 1.03; 95% CI 1.01, 1.03; p<0.0001) but not in IPF (HR 1.00; 95% CI 0.97, 1.04; p=0.70). DI was associated with mortality on both univariate and multivariate analysis in the combined patient sub-group with NSIP or CTD-ILD; and in the combined patient sub-group with an immune-mediated ILD (NSIP, HP, CTD-ILD, sarcoidosis) (HR 1.03; 95% CI 1.01, 1.06; p=0.001).
Conclusion: DI is more prevalent and it is a stronger predictor of mortality in immune-mediated ILDs than in IPF and may be an important manifestation of these disorders.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA5196.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019