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Traction Bronchiectasis/Bronchiolectasis is Associated with Interstitial Lung Abnormality Mortality.

Tomoyuki Hida1, Mizuki Nishino2, Takuya Hino2

  • 1Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA; Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 8128582, Japan.

European Journal of Radiology
|June 2, 2020
PubMed
Summary

Traction bronchiectasis/bronchiolectasis in idiopathic pulmonary fibrosis (IPF) is linked to reduced survival. The severity of this condition significantly impacts mortality risk in IPF patients.

Keywords:
Age Gene/Environment Susceptibility-Reykjavik StudyInterstitial lung abnormalityPulmonary fibrosisTraction bronchiectasisUsual interstitial pneumonia

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Area of Science:

  • Pulmonary Medicine
  • Radiology
  • Epidemiology

Background:

  • Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with significant mortality.
  • Traction bronchiectasis/bronchiolectasis is a common finding in IPF, reflecting lung distortion.
  • The prognostic value of traction bronchiectasis/bronchiolectasis in IPF requires further elucidation.

Purpose of the Study:

  • To investigate the association between the presence and severity of traction bronchiectasis/bronchiolectasis and overall survival in subjects with IPF.
  • To determine if traction bronchiectasis/bronchiolectasis contributes to increased mortality in IPF patients.

Main Methods:

  • Retrospective analysis of 3,594 subjects from the AGES-Reykjavik Study (378 with IPF, 3,216 without).
  • Chest CT scans of IPF subjects were evaluated for traction bronchiectasis/bronchiolectasis and categorized using a Traction Bronchiectasis/bronchiolectasis Index (TBI).
  • Overall survival (OS) was compared among different TBI groups and subjects without IPF using multivariable Cox models, adjusting for age, sex, and smoking status.

Main Results:

  • Median OS varied significantly with TBI severity: 11.95 years (TBI-0), 8.52 years (TBI-1), 7.63 years (TBI-2), and 5.40 years (TBI-3).
  • Subjects with TBI-1, TBI-2, and TBI-3 showed significantly shorter OS compared to subjects without IPF (P < 0.0001).
  • TBI-0 group (IPF without traction bronchiectasis/bronchiolectasis) had no significant difference in OS compared to subjects without IPF.

Conclusions:

  • The presence and severity of traction bronchiectasis/bronchiolectasis are significantly associated with poorer survival in IPF patients.
  • Traction bronchiectasis/bronchiolectasis is a crucial factor contributing to increased mortality in individuals with IPF.
  • Quantifying traction bronchiectasis/bronchiolectasis severity can aid in risk stratification and prognosis for IPF.