title: The predictors of mortality in IPF - Does emphysema change the prognosis?
abstract: BACKGROUND
  Combined idiopathic pulmonary fibrosis (IPF) and emphysema (CPFE) has been reported to be more common in male smokers. A number of studies comparing CPFE patients with fibrosis-only patients have reported a similar prognosis while others have reported a significantly shorter survival.
  
  
  OBJECTIVE
  In present study, we aimed to compare baseline characteristics of patients with IPF according to emphysema presence. We asssessed the prognostic value of emphysema along with each other parameter.
  
  
  METHODS
  We retrospectively reviewed the clinical, baseline radiological, laboratory and physiological parameters of 92 patients who were diagnosed with IPF. The patients were divided into two groups: those without emphysema (Group 1) and with emphysema (Group 2). All-cause mortality was recorded, and the impact of the variables on survival was evaluated.
  
  
  RESULTS
  Emphysema was recorded in 23 patients, all of whom were male. While ever-smoker rate was higher in Group 2 laboratory and physiologic parameters were similar. Radiologically, the presence of honeycombing, ground glass opacity, the extension and symmetry of involvement did not differ between the Groups. The median survival time was 29±4 months. Patients in Group 1 and 2 had a median survival of 34 and 9 months, respectively. In univariate analysis; radiological presence of emphysema and honeycombing, male gender, lower baseline levels of albumin and oxygen saturation, forced vital capacity and carbon monoxide diffusing capacity were detected as predictors of mortality.
  
  
  CONCLUSIONS
  In present study, IPF with emphysema was more common in male smokers. When emphysema accompanies IPF, life expectancy is remarkably worse, but not independently so.
authors.affiliation: Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital. fatmatokgoz86@gmail.com.
authors.forename: Fatma
authors.initials: F
authors.lastname: Tokgoz Akyıl
authors.forename: Tülin
authors.initials: T
authors.lastname: Sevim
authors.forename: Canan
authors.initials: C
authors.lastname: Akman
authors.forename: Emine
authors.initials: E
authors.lastname: Aksoy
authors.forename: Meltem
authors.initials: M
authors.lastname: Ağca
authors.forename: Oguz
authors.initials: O
authors.lastname: Aktas
authors.forename: Mustafa
authors.initials: M
authors.lastname: Akyıl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002423:Cause of Death; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000097:blood / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010100:Oxygen / Q000097:blood; D011379:Prognosis; D016016:Proportional Hazards Models; D011653:Pulmonary Diffusing Capacity; D011656:Pulmonary Emphysema / Q000097:blood / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D000075462:Serum Albumin, Human; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014797:Vital Capacity
chemical_list: C422455:ALB protein, human; D015415:Biomarkers; D012709:Serum Albumin; D010100:Oxygen; D000075462:Serum Albumin, Human
keywords: Emphysema; honeycombing; idiopathic pulmonary fibrosis; prognosis; survival