The prognostic significance of pneumothorax in patients with idiopathic pulmonary fibrosis

Abstract

These results confirm that patients with IPF often develop pneumothorax during their clinical course and that the onset of pneumothorax predicts a poor outcome.

Secondary spontaneous pneumothorax in idiopathic pulmonary fibrosis: Grim news

“…The median survival time from the onset of (first) SSP was 13.3 months, thus suggesting that this complication is ominous. In fact, during the observation period, the mortality rate was significantly higher in patients with SSP than in those without SSP (82.4% vs 41.8%) . Contrary to the results of a previous study, a multivariate analysis supported SSP as an independent predictor of mortality (hazards ratio = 2.85), after adjusting for a number of confounding factors, such as age, gender and baseline forced vital capacity .…”

“…It can hypothetically be attributed to the rupture of subpleural areas of honeycombing cysts. In contrast, the frequent coexistence of pulmonary fibrosis and emphysema does not seem to be a causative factor, since this and an earlier study were not able to demonstrate a significantly greater prevalence of emphysematous changes in IPF patients suffering from SSP. Nor does the potential miscategorization of pleuroparenchymal fibroelastosis as IPF seem to be a convincing explanation.…”

“…Also, in the study by Nishimoto et al, 17 of 84 (20%) IPF patients developed SSP, with a cumulative increasing incidence over time. 4 SSP was more likely in IPF patients with a lower body mass index and extensive reticular abnormalities on computed tomography. The median survival time from the onset of (first) SSP was 13.3 months, thus suggesting that this complication is ominous.…”

“…The article by Nishimoto et al . in this issue highlights the clinical relevance of another well known, but poorly reported complication of IPF, namely the appearance of a secondary spontaneous pneumothorax (SSP) . Needless to say, pneumothorax in this population may also follow a transbronchial lung biopsy (incidence of 7.2% in a recent study), but data regarding the prognostic influence of iatrogenic pneumothorax on IPF outcome are lacking.…”

“…The initial SSP occurred at a mean of 9.1 months before death. Also, in the study by Nishimoto et al ., 17 of 84 (20%) IPF patients developed SSP, with a cumulative increasing incidence over time . SSP was more likely in IPF patients with a lower body mass index and extensive reticular abnormalities on computed tomography.…”