Clusters of comorbidities in idiopathic pulmonary fibrosis

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

DOI

  • Thomas Skovhus Prior
  • Nils Hoyer, Københavns Universitet
  • ,
  • Ole Hilberg, Syddansk Universitet
  • ,
  • Saher Burhan Shaker, Københavns Universitet
  • ,
  • Jesper Rømhild Davidsen, Syddansk Universitet
  • ,
  • Finn Rasmussen
  • ,
  • Elisabeth Bendstrup

Introduction: Comorbidities are common in patients with idiopathic pulmonary fibrosis (IPF) and negatively impact health-related quality of life, health-care costs and mortality. Retrospective studies have focused on individual comorbidities, but clusters of multiple comorbidities have rarely been analysed. This study aimed to comprehensively and prospectively assess comorbidities in a multicentre, real-world cohort of patients with IPF, including prespecified conditions of special interest and to analyse clusters of comorbidities and examine characteristics, disease course and mortality of the clusters. Methods: Several measurements, questionnaires, medications and medical history were combined to assess comorbidities. Using self-organizing maps, clusters of comorbidities were identified and phenotypes characterized. Disease course was assessed using mixed effects models and mortality using Cox regression. Results: One-hundred and fifty IPF patients were included prospectively. All except one patient suffered from at least one comorbidity and multimorbidity was common. Arterial hypertension, gastro-oesophageal reflux disease, hypercholesterolemia, emphysema and obstructive sleep apnea were most prevalent. Four comorbidity clusters were identified. Each cluster had distinct comorbidity profiles, patient characteristics, symptom burden and disease severity. Patients with fewer comorbidities had better exercise capacity and less dyspnea at baseline, but a trend towards faster deterioration was observed. Mortality analyses showed no significant differences between clusters. Conclusions: Multimorbidity is prevalent in patients with IPF. Four specific clusters of comorbidities may represent phenotypes in IPF. A trend towards faster decline in exercise capacity and dyspnea was observed in patients with fewer comorbidities. Increased knowledge of comorbidities facilitates prevention and treatment of comorbidities in patients with IPF.

OriginalsprogEngelsk
Artikelnummer106490
TidsskriftRespiratory Medicine
Vol/bind185
Antal sider8
ISSN0954-6111
DOI
StatusUdgivet - aug. 2021

Bibliografisk note

Funding Information:
The study was supported by grants from TrygFonden (grant 118860 ), Aarhus University (unrestricted), Boehringer Ingelheim Denmark (unrestricted), the Danish Lung Association's Fund , the Health Research Fund of the Central Denmark Region and the Ellen and Knud Dalhoff Larsen's Fund . The funders of the study had no role in study design, data collection, data analyses, data interpretation, writing of the report or decision to submit the paper for publication.

Publisher Copyright:
© 2021 The Author(s)

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