INTRODUCTION Chronic Hypersensitivity Pneumonitis (cHP) is a fibrotic interstitial lung disease (ILD) resulting from repeated exposure to an offending antigen. Prognostication in cHP remains challenging, and the relationship between comorbidities and survival has yet to be characterized. The aim of this study was to describe the relationship between comorbid conditions and survival in patients with cHP. METHODS The prospective database from a tertiary referral centre for ILD was reviewed for patient-reported comorbidities, their frequency, and relationship with survival in cHP patients. Comorbidities were assessed by direct questioning of the patient at the baseline visit and by a standardized questionnaire for the diagnosis of interstitial lung diseases. During the follow-up examinations, patients were asked about newly diagnosed comorbidities. RESULTS Two hundred eleven patients with cHP were identified (mean age 63 years, 53% male, mean FVC 73%), with mean follow-up of 32 months. The mean number of comorbidities was 3 (10% had 0, 59% 1-3 and 31% ≥4 comorbidities). Most frequent comorbidities groups were cardiovascular (65%) and respiratory (26%), most common comorbidities were hypertension (56%), gastro-esophageal reflux disease (GERD) (24%), diabetes (20%) and coronary heart disease (18%). In general, deceased patients had more comorbidities than survivors (p = 0.005), yet there was no association between the absolute number of comorbidities and survival. Pulmonary hypertension (30.8% versus 5.7%, p = 0.001;), diastolic dysfunction (26.9% versus 6.4%, p = 0.004) and cerebrovascular disease were more frequent in non-survivors (23.1% versus 7.6%, p = 0.026). Lung cancer was not observed, and neither GERD nor antacid drugs were associated with outcome (p = 0.357 and p = 0.961, respectively). CONCLUSIONS Comorbidities are common in cHP are associated with survival. Further work should determine whether interventions for these specific comorbidities can positively affect survival.

中文翻译：

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慢性超敏性肺炎患者的合并症和生存率。

引言慢性超敏性肺炎（cHP）是一种纤维化的间质性肺病（ILD），是由反复暴露于有问题的抗原引起的。cHP的预后仍然具有挑战性，并且合并症和生存之间的关系尚未确定。这项研究的目的是描述合并疾病的状况与cHP患者的生存率之间的关系。方法回顾了来自ILD的三级转诊中心的前瞻性数据库，以了解患者报告的合并症，其发生频率以及与cHP患者生存率的关系。通过在基线访视时直接询问患者以及通过诊断间质性肺疾病的标准化问卷来评估合并症。在随访检查中，询问患者有关新诊断的合并症。结果确定了211例cHP患者（平均年龄63岁，男性53％，平均FVC 73％），平均随访32个月。合并症的平均数为3（10％的合并症为0、59％1-3和31％≥4合并症）。最常见的合并症是心血管疾病（65％）和呼吸道疾病（26％），最常见的合并症是高血压（56％），胃食管反流病（GERD）（24％），糖尿病（20％）和冠心病（ 18％）。通常，死者的合并症多于幸存者（p = 0.005），但合并症的绝对数量与存活率之间没有关联。非幸存者的肺动脉高压（30.8％对5.7％，p = 0.001；），舒张功能障碍（26.9％对6.4％，p = 0.004）和脑血管疾病的发生率更高（23.1％对7.6％，p = 0.026）。未观察到肺癌，GERD和抗酸药均与预后无关（分别为p = 0.357和p = 0.961）。结论共病在cHP中很常见，与生存有关。进一步的工作应确定针对这些特定合并症的干预措施是否可以积极影响生存。