title: The impact of combined pulmonary fibrosis and emphysema on mortality.
abstract: METHODS
  The impact on patient mortality of combined pulmonary fibrosis and emphysema (CPFE) compared with emphysema alone has never been investigated.
  
  
  OBJECTIVE
  To elucidate whether CPFE has an impact on overall mortality over that of emphysema alone.
  
  
  METHODS
  We screened patients who underwent chest computed tomography (CT) scans during the period from 1 January 2001 to 31 December 2005 in a tertiary referral hospital. Patients who had both emphysema and pulmonary fibrosis, thus meeting the inclusion criteria, were defined as CPFE. Controls with emphysema alone who were matched for age, sex and the date of CT scan were randomly selected. Cox proportional regression analysis was performed to verify whether CPFE is associated with increased overall mortality.
  
  
  RESULTS
  We found 135 CPFE cases. In the multivariable Cox regression stratified by the presence of comorbid malignancy, CPFE had five times higher mortality risk (adjusted HR 5.10, 95%CI 1.75-14.9) in non-malignant cases, and showed a statistically insignificant trend for higher mortality risk (adjusted HR 1.70, 95%CI 0.94-2.51) in the malignant cases after adjusting for forced vital capacity, height and hypertension.
  
  
  CONCLUSIONS
  CPFE is not rare and CPFE patients had a higher overall mortality risk than emphysema-only patients.
authors: Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors: C-H
authors: CH
authors: Lee
authors: H J
authors: HJ
authors: Kim
authors: C M
authors: CM
authors: Park
authors: K Y
authors: KY
authors: Lim
authors: J Y
authors: JY
authors: Lee
authors: D J
authors: DJ
authors: Kim
authors: J H
authors: JH
authors: Yeon
authors: S-S
authors: SS
authors: Hwang
authors: D-K
authors: DK
authors: Kim
authors: S-M
authors: SM
authors: Lee
authors: J-J
authors: JJ
authors: Yim
authors: S-C
authors: SC
authors: Yang
authors: C-G
authors: CG
authors: Yoo
authors: H S
authors: HS
authors: Chung
authors: Y W
authors: YW
authors: Kim
authors: S K
authors: SK
authors: Han
authors: Y-S
authors: YS
authors: Shim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D006785:Hospitals, University; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging / Q000401:mortality*; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging / Q000401:mortality*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed