MORTALITY IN CHRONIC HYPERSENSITIVITY PNEUMONITIS

TYPE: Abstract Publication TOPIC: Diffuse Lung Disease PURPOSE: The clinical course of interstitial lung diseases (ILDs) is difficult to predict, mainly due to its heterogeneity. The aim of this study was to perform a detailed characterization of a chronic Hypersensitivity Pneumonitis (cHP) cohort and to identify potential mortality predictors. METHODS: Retrospective analysis of Chronic Hypersensitivity Pneumonitis patients, followed in an ILD outpatient department. Clinical, functional and radiological data were obtained. RESULTS: We included 49 patients (17 male and 32 female), with a median age of 71 years (45-84 years). Considering ILD-GAP, the patients were divided: 42.9%(n=21) - 0-1 category; 38.8%(n=19)-2-3 category; 16.3%(n=8) - 4-5 category and 2.0%(n=1) - >5 category. Fourteen patients (28.6%) died during follow-up and the median survival time was 29.0 months(5-55). 10.2%(n=5) of patients died in the first year of follow-up (ILD-GAP category: 2 patients were on group 2-3; 2 patients were on group 4-5; and one patient was on group>5). One death in the 2-3 category was not related to pulmonary disease. In univariate analysis, the variable death was associated with gender (p=0.039), FVC(p<0.001), DLCO(p=0,012), oxygen supplementation(p=0.003), ILD-GAP(p<0.001) and prior exacerbation(p<0.001). After multivariate analysis, only FVC and history of exacerbations remained statistically significant associated with mortality (HR 0.9; p=0.012; IC 0.82-0,98 and HR 18.8, p=0.001; IC 3.5-101.5). CONCLUSIONS: According to the literature, the lung function and prior history of exacerbations seem to be predictors of mortality in this group of chronic HP patients. CLINICAL IMPLICATIONS: Previous exacerbation and decline in lung function seem to be mortality predictors in cHP, as described for IPF. So, these patients must be under a close surveillance. DISCLOSURE: No significant relationships. KEYWORDS: Hypersensitivity Pneumonitis, Mortality, ILD-GAP