Emphysema ‘does not increase mortality in pulmonary fibrosis’
MedWire News: Patients with combined pulmonary fibrosis and emphysema (CPFE) do not have greater mortality rates than those with pulmonary fibrosis alone, study findings suggest.
Previous studies have shown that pulmonary fibrosis and emphysema can coexist and the combination is associated with preserved lung function, but significant reductions in gas exchange and a high prevalence of pulmonary hypertension compared with pulmonary fibrosis alone.
However, although "physiologic changes in CPFE are well documented, there is little mortality data in the CPFE population compared to appropriate controls," explain Matthew Jankowich and Sharon Rounds from (Providence Veteran's Affairs Medical Center, Rhode Island, USA).
To address this, the researchers studied retrospective data on 44 patients hospitalized for pulmonary fibrosis between 2003 and 2008. Of these, 20 patients showed evidence of emphysema on computed tomography scans.
The team found that, overall, patients with CPFE had larger lung volumes than those with pulmonary fibrosis alone, at a forced vital capacity (FVC) of 77% versus 62% of the predicted value.
However, CPFE patients had greater levels of airflow obstruction, as indicated by a FEV1/FVC ratio of 0.67 versus 0.78 in those with pulmonary fibrosis alone, as well as worse gas exchange and a greater prevalence of pulmonary hypertension.
A high proportion of patients in the CPFE group (65%) and the pulmonary fibrosis alone group (71%) died during the 5-year study period, but the difference in mortality rates was not significant, after accounting for age and other factors.
Jankowich and Rounds conclude in the journal Lung: "Our study does not support worsened survival in individuals with CPFE than with pulmonary fibrosis alone."
They add: "Further definition of the natural history of CPFE is needed."
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By Mark Cowen