Radiological determinants of overall survival in a Turkish cohort of patients with hypersensitivity pneumonitis

Résumé fourni par la source

Background: To assess whether computed tomography imaging features associate with survival in fibrotic hypersensitivity pneumonitis (HP). Methods: Consecutive patients with volumetric CTs from Izmir, Turkey, diagnosed with HP by multidisciplinary team evaluation were studied. Honeycombing, reticulation and ground glass opacification were measured semi-quantitatively by a thoracic radiologist. Survival analyses using Cox proportional hazards models, were initially adjusted using age, gender, FVC (%-predicted) and designation of HP (typical, compatible, indeterminate). This was compared to a model additionally adjusted using: pulmonary artery diameter (mm), honeycombing, reticulation and ground glass opacification (all % of lung). Results: Of 157 participants 101 died over the study period: median age=65 (IQR=58, 72) males=59%; median follow up time=2.9 years (IQR=1.24, 5.51 years). FVC (%-predicted) was associated with worse survival (HR=0.98, 0.96-0.99, p<0.001). Higher extent of all three radiological measures: honeycombing, (HR=1.08, 1.03-1.14, p=0.003), reticulation (HR=1.04, 1.01-1.03, p<0.001) and ground glass opacification (HR=1.02, 1.01-1.03], p=0.003) were associated with worse survival. A model combining FVC and radiological measures showed an improved C-index (0.76) compared to the model with clinical variables only (0.70). Interpretation: Semi-quantitative measures of interstitial damage predict survival in HP patients.

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