University of Oulu

Kärkkäinen, M., Kettunen, H., Nurmi, H., Selander, T., Purokivi, M., Kaarteenaho, R. (2017) Effect of smoking and comorbidities on survival in idiopathic pulmonary fibrosis. Respiratory Research, 18 (1). doi:10.1186/s12931-017-0642-6

Effect of smoking and comorbidities on survival in idiopathic pulmonary fibrosis

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Author: Kärkkäinen, Miia1,2; Kettunen, Hannu-Pekka3; Nurmi, Hanna2,4;
Organizations: 1The Center of Medicine and Clinical Research, Division of Respiratory Medicine, Kuopio University Hospital
2Division of Respiratory Medicine, Institute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland
3Department of Clinical Radiology, Kuopio University Hospital
4Harjula Hospital, the Municipal Hospital of Kuopio
5The Science Services Center, Kuopio University Hospital
6Respiratory Medicine, Internal Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2017111050578
Language: English
Published: Springer Nature, 2017
Publish Date: 2017-11-10
Description:

Abstract

Background: Cigarette smoking has been associated with the risk of idiopathic pulmonary fibrosis (IPF). Certain comorbidities have been associated with reduced survival although some studies have indicated that current smokers have a longer survival than ex-smokers. Comorbidities in relation to smoking history have not been previously analyzed.

Methods: Retrospective data was collected and patients were categorized according to gender and smoking habits. Comorbidities and medications were collected. Predictive values for mortality were identified by COX proportional hazard analyses.

Results: We examined 45 non-smokers (53.3% female), 66 ex-smokers (9.1% female) and 17 current smokers (17.6% female) with IPF. Current smokers were younger at baseline (58.1 ± 8.74 years) compared to non-smokers (71.4 ± 8.74, p < 0.001) and ex-smokers (72.5 ±7.95, p <0.001). Median survival of non-smokers and current smokers was longer (55.0 and 52.0 months, respectively) than that of ex-smokers (36.0 months) (p=0.028 and 0.034, respectively). In age and severity adjusted analyses, smoking was not related to survival. Cardiovascular diseases (CVD) (72.7 %) were the most common comorbidities, current smokers had more chronic obstructive pulmonary disease (COPD) and lung cancer compared to ex-smokers (p<0.001). CVD, COPD and use of insulin were related to poorer survival in adjusted analyses.

Conclusions: Smoking seems to influence the course of disease in IPF since current smokers developed the disease at a younger age in comparison to non-smokers and ex-smokers. No significant differences in the major comorbidities were detected between IPF patients with different smoking histories. The mechanism through which smoking influences IPF progression requires further investigation.

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Series: Respiratory research
ISSN: 1465-9921
ISSN-E: 1465-993X
ISSN-L: 1465-9921
Volume: 18
Issue: 1
Article number: 160
DOI: 10.1186/s12931-017-0642-6
OADOI: https://oadoi.org/10.1186/s12931-017-0642-6
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 Internal medicine
Subjects:
Funding: M. K. has received grants for scientific work from the Foundation of the Finnish Anti-Tuberculosis Association, the Organization for Respiratory Health in Finland, the Väinö and Laina Kivi Foundation, the Kuopio Region Respiratory Foundation and the Jalmari and Rauha Ahokas Foundation; H.N. has received grants for scientific work from the Foundation of the Finnish Anti-Tuberculosis Association, the Organization for Respiratory Health in Finland, the Väinö and Laina Kivi Foundation, the Kuopio Region Respiratory Foundation and the Jalmari and Rauha Ahokas Foundation; M.P. received grants for scientific work from the Research Director of Kuopio University Hospital, the Foundation of the Finnish Anti-Tuberculosis Association and the Jalmari and Rauha Ahokas Foundation; R. K. has received grants for scientific work and for the research team from the state subsidy of Kuopio University Hospital, the Foundation of The Finnish Anti-Tuberculosis Association and the Kuopio Region Respiratory Foundation.
Dataset Reference: The datasets generated during and analyzed during the current study are not publicly available due to the relatively small population of eastern Finland since we could not guarantee individuals’ anonymity as the data was collected in a detailed manner, but it is available from the corresponding author on reasonable request.
Copyright information: © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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