Cough predicts prognosis in idiopathic pulmonary fibrosis
Cough predicts prognosis in idiopathic pulmonary fibrosis
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DOI：
10.1111/j.1440-1843.2011.01996.x
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发表时间：
2011-08-01
期刊：
影响因子：
6.9
通讯作者：
Collard, Harold R.
中科院分区：
文献类型：
--
作者：
Ryerson, Christopher J.;Abbritti, Marta;Collard, Harold R.
背景与目的：IPF患者咳嗽的临床相关性和预后价值尚未得到充分的描述。本研究的目的是描述IPF患者咳嗽的特征和预后价值。方法：从正在进行的纵向数据库中确定IPF受试者。前瞻性记录咳嗽及其他临床变量。使用Logistic回归来确定咳嗽的预测因子和疾病进展的预测因子，定义为FVC下降10%，DLCO下降15%，肺移植或6个月内就诊死亡。采用Cox比例风险分析分析咳嗽与死亡时间或肺移植的关系。结果：共纳入242名受试者。84%的受试者报告咳嗽。在多因素分析中，既往吸烟者咳嗽的可能性较低（OR 0.07, 95% CI: 0.01-0.55, P = 0.01），而运动去饱和（OR 2.56, 95% CI: 1.15-5.72, P = 0.02）和FVC较低（OR 0.76, 95% CI: 0.60-0.96, P = 0.02）的受试者咳嗽的可能性较高。咳嗽预测疾病进展（OR 4.97, 95% CI: 1.25-19.80, P = 0.02），独立于疾病严重程度，并可预测死亡时间或肺移植时间（HR 1.78, 95% CI: 0.94-3.35, P = 0.08）。结论：IPF患者咳嗽在不吸烟和疾病晚期患者中更为普遍。咳嗽是疾病进展的独立预测因子，可预测死亡时间或肺移植时间。
Background and objective: The clinical associations and prognostic value of cough in IPF have not been adequately described. The objective of this study was to describe the characteristics and prognostic value of cough in IPF.Methods: Subjects with IPF were identified from an ongoing longitudinal database. Cough and other clinical variables were recorded prospectively. Logistic regression was used to determine predictors of cough and predictors of disease progression, defined as 10% decline in FVC, 15% decline in DLCO, lung transplantation or death within 6 months of clinic visit. The relationship of cough with time to death or lung transplantation was analysed using Cox proportional hazards analysis.Results: Two hundred and forty-two subjects were included. Cough was reported in 84% of subjects. On multivariate analysis, cough was less likely in previous smokers (OR 0.07, 95% CI: 0.01-0.55, P = 0.01), and more likely in subjects with exertional desaturation (OR 2.56, 95% CI: 1.15-5.72, P = 0.02) and lower FVC (OR 0.76, 95% CI: 0.60-0.96, P = 0.02). Cough predicted disease progression (OR 4.97, 95% CI: 1.25-19.80, P = 0.02) independent of disease severity, and may predict time to death or lung transplantation (HR 1.78, 95% CI: 0.94-3.35, P = 0.08).Conclusions: Cough in IPF is more prevalent in never-smokers and patients with more advanced disease. Cough is an independent predictor of disease progression and may predict time to death or lung transplantation.