S19 The impact of clotting abnormalities on the natural history of idiopathic pulmonary fibrosis: an extended follow up of a population based cohort

IntroductionIdiopathic pulmonary fibrosis (IPF) has an unpredictable course corresponding to various profiles: stability, physiological disease progression and rapid decline. A minority of patients experience acute exacerbations (AEs). A recent study suggested that ozone and nitrogen dioxide might contribute to the occurrence of AE. We hypothesised that outdoor air pollution might influence the natural history of IPF.MethodsPatients were selected from the French cohort COhorte FIbrose (COFI), a national multicentre longitudinal prospective cohort of IPF (n=192). Air pollutant levels were assigned to each patient from the air quality monitoring station closest to the patient’s geocoded residence. Cox proportional hazards model was used to evaluate the impact of air pollution on AE, disease progression and death.ResultsOnset of AEs was significantly associated with an increased mean level of ozone in the six preceding weeks, with an HR of 1.47 (95% CI 1.13 to 1.92) per 10 µg/m3 (p=0.005). Cumulative levels of exposure to particulate matter PM10 and PM2.5 were above WHO recommendations in 34% and 100% of patients, respectively. Mortality was significantly associated with increased levels of exposure to PM10 (HR=2.01, 95% CI 1.07 to 3.77) per 10 µg/m3 (p=0.03), and PM2.5 (HR=7.93, 95% CI 2.93 to 21.33) per 10 µg/m3 (p<0.001).ConclusionThis study suggests that air pollution has a negative impact on IPF outcomes, corroborating the role of ozone on AEs and establishing, for the first time, the potential role of long-term exposure to PM10 and PM2.5 on overall mortality.

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Idiopathic Pulmonary Fibrosis: The Epidemiology and Natural History of Disease

Respiratory Medicine - Idiopathic Pulmonary Fibrosis ◽

10.1007/978-3-319-99975-3_2 ◽

2018 ◽

pp. 11-35 ◽

Cited By ~ 1

Author(s):

Michael P. Mohning ◽

Jeffrey J. Swigris ◽

Amy L. Olson

Keyword(s):

Natural History ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

History Of Disease ◽

History Of

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Prevalence, risk factors, and impact of lung cancer on outcomes of idiopathic pulmonary fibrosis: a study from the Middle East

Multidisciplinary Respiratory Medicine ◽

10.4081/mrm.2018.191 ◽

2018 ◽

Vol 13 ◽

Author(s):

Sherif Mohamed ◽

Hassan Bayoumi ◽

Nashwa Abd El-Aziz ◽

Ehab Mousa ◽

Yasser Gamal

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Odds Ratio ◽

Independent Predictor ◽

Significant Independent Predictor ◽

Upper Egypt ◽

The Impact

Background: No studies have addressed the impact of lung cancer (LC) on prognosis of patients with idiopathic pulmonary fibrosis (IPF) in Upper Egypt. We aimed to evaluate the prevalence and risk factors for LC among IPF patients and its impact on their outcomes and survival in Upper Egypt. Methods: A total of 246 patients with IPF who had complete clinical and follow up data were reviewed. They were categorized into 2 groups: 34 patients with biopsy-proven LC and IPF (LC-IPF) and 212 patients with IPF only (IPF). Survival and clinical characteristics of the two groups were compared. Results: Prevalence of LC was 13.8%. Pack/years was the most significant predictor for LC development in IPF (Odds ratio; 3.225, CI 1.257–1.669, p = 0.001). Survival in patients with LC-IPF was significantly worse than in patients with IPF without LC; median survival, 35 months vs 55 months; p = 0.000. LC accompanying IPF was one of the most significant independent predictors of survival in IPF patients (Hazard ratio 5.431, CI 2.186–13.492, p = 0.000). Mortality in LC-IPF patients was mainly due to LC progression in 36% and LC therapy-related complications in 22%. Conclusions: Prevalence of LC in IPF patients was 13.8%. Lung cancer has significant impacts on patients with IPF in Upper Egypt, in terms of clinical outcomes and survival. Smoking is the most significant independent predictor of LC development in IPF patients. A poorer survival was observed for patients with IPF developing LC, mainly due to LC progression, and to complications of its therapies. Further prospective, multicenter and larger studies are warranted.

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Mo1806 Natural History of Perianal Crohn's Disease: Long-Term Follow-Up on a Population-Based Cohort

Gastroenterology ◽

10.1016/s0016-5085(16)32649-x ◽

2016 ◽

Vol 150 (4) ◽

pp. S781-S782

Author(s):

Rabilloud Marie-Laure ◽

Charlène Brochard ◽

Emma Bajeux ◽

Siproudhis Laurent ◽

Jean-François Viel ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Natural History ◽

Population Based ◽

Perianal Crohn’S Disease ◽

Long Term Follow Up ◽

History Of ◽

Perianal Crohn's Disease

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The Natural History of Ossification of Yellow Ligament of the Thoracic Spine on MRI: A Population-Based Cohort Study

Global Spine Journal ◽

10.1177/2192568220903766 ◽

2020 ◽

pp. 219256822090376 ◽

Cited By ~ 1

Author(s):

Chris Yuk Kwan Tang ◽

Kenneth Man Chee Cheung ◽

Dino Samartzis ◽

Jason Pui Yin Cheung

Keyword(s):

Cohort Study ◽

Natural History ◽

Thoracic Spine ◽

Population Based ◽

Close Monitoring ◽

Level Of Evidence ◽

Southern Chinese ◽

History Of ◽

Prospective Longitudinal

Purpose: To assess the natural history of ossification of yellow ligament (OYL) in the thoracic spine and determine risk factors for progression based on a longitudinal population-based cohort. Methods: A prospective, longitudinal cohort study was performed on a population-based cohort of Southern Chinese volunteers. T2-weighted magnetic resonance imaging (MRI) was used at baseline to identify any OYL and was verified with computed tomography. Follow-up MRI was performed 5 years later. Parameters under study included the size of OYL, levels of involvement, morphology (round, triangular, beak), whether it crossed the midline and any disc degeneration. Results: A total of 114 (6.1%) individuals were identified to have OYL at baseline out of the 1864 individuals. Size progression occurred predominantly at the lower thoracic region. Majority of the new OYL were also in the lower thoracic spine and was associated with higher body mass index (BMI). Smokers were associated with OYL size progression while patients with higher BMI tended to develop new OYL at follow-up. Progression commonly occurred at the lower thoracic levels and regression occurred mostly at the upper thoracic levels. Conclusions: This is the first population-based series addressing the natural history of OYL. Better understanding of the natural history of OYL may provide incentive to introduce preventive measures such as weight reduction and close monitoring for myelopathy development in those at-risk groups for progression. This is especially important for patients with lower thoracic OYL and who are smokers with higher BMI. Level of Evidence: 1 (prognostic study).

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P286 Rate of colectomy in ulcerative colitis: Results from a Spanish cohort with 15 years of follow-up

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.415 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S295-S296

Author(s):

C Rodriguez Gutiérrez ◽

A Elosua Gonzalez ◽

C Prieto Martínez ◽

S Rubio Iturria ◽

M A Vicuña ◽

...

Keyword(s):

Ulcerative Colitis ◽

Natural History ◽

Therapeutic Strategies ◽

Definitive Diagnosis ◽

Biological Drugs ◽

History Of ◽

Incident Cohort ◽

The Impact ◽

Spanish Cohort

Abstract Background Knowing the natural history of ulcerative colitis (UC) is essential to understand the evolution of the disease, assess the impact of different therapeutic strategies, identify poor prognostic factors and provide patients with understandable information who help them in decision making. It has been suggested that biological drugs could modify natural history of UC and therefore decrease the rates of colectomy. In Spain, infliximab is approved for CU since 2005. Methods We performed a retrospective study that includes all patients with a definitive diagnosis (DD) of UC or Unclassifiable Colitis (UC) in the Navarra Incident Cohort (which includes all patients diagnosed between 2001 and 2003 in Navarra, Spain). Our objectives were to analyse the Colectomy Incidence Rate (CIR) from diagnosis to the end of follow-up (12-31-2017) and identify predictive factors of colectomy. Results We included 174 patients with DD of UC (42.5% E2 - 26.8% E3) and 5 of IC: 44.1 women, median age 39.2 years (7–88), median follow-up of 15.7 years. At the end of the follow-up, 8 patients underwent colectomy (CIR 3 surgeries per 100000patients-year). Timing of colectomy was: 3 at the initial diagnosis (<1 month), 2 in the first 2 years, 2 at 5 years and 1 at 12 years from diagnosis. All had previously received steroids, 5 immunomodulators and 2 biological agents. In 7 (87%) the surgery was urgent and the indication, megacolon in 3 (37.5%), severe outbreak in 3 (37.5%) and failure to medical treatment in 2 (25%). In 5 cases (62.5%), an ileoanal reservoir was made and in 3 definitive ileostomy. Conclusion In our cohort, global colectomy rates are lower than those reported in other series and occur mostly in the first 5 years of evolution.

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The Canadian Registry for Pulmonary Fibrosis: Design and Rationale of a National Pulmonary Fibrosis Registry

Canadian Respiratory Journal ◽

10.1155/2016/3562923 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 11

Author(s):

Christopher J. Ryerson ◽

Benjamin Tan ◽

Charlene D. Fell ◽

Hélène Manganas ◽

Shane Shapera ◽

...

Keyword(s):

Natural History ◽

Pulmonary Fibrosis ◽

Health Services ◽

Self Report ◽

Administrative Databases ◽

Health Services Use ◽

Acute Exacerbations ◽

History Of ◽

The Impact ◽

Services Use

Background. The relative rarity and diversity of fibrotic interstitial lung disease (ILD) have made it challenging to study these diseases in single-centre cohorts. Here we describe formation of a multicentre Canadian registry that is needed to describe the outcomes of fibrotic ILD and to enable detailed healthcare utilization analyses that will be the cornerstone for future healthcare planning.Methods. The Canadian Registry for Pulmonary Fibrosis (CARE-PF) is a prospective cohort anticipated to consist of at least 2,800 patients with fibrotic ILD. CARE-PF will be used to (1) describe the natural history of fibrotic ILD, specifically determining the incidence and outcomes of acute exacerbations of ILD subtypes and (2) determine the impact of ILD and acute exacerbations of ILD on health services use and healthcare costs in the Canadian population. Consecutive patients with fibrotic ILD will be recruited from five Canadian ILD centres over a period of five years. Patients will be followed up as clinically indicated and will complete standardized questionnaires at each clinic visit. Prespecified outcomes and health services use will be measured based on self-report and linkage to provincial health administrative databases.Conclusion. CARE-PF will be among the largest prospective multicentre ILD registries in the world, providing detailed data on the natural history of fibrotic ILD and the healthcare resources used by these patients. As the largest and most comprehensive cohort of Canadian ILD patients, CARE-PF establishes a network for future clinical research and early phase clinical trials and provides a platform for translational and basic science research.

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