{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:06:27Z","timestamp":1791216387208,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T00:00:00Z","timestamp":1692662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["T32DK007533\u201035"],"award-info":[{"award-number":["T32DK007533\u201035"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Gastroesophageal reflux has been associated with idiopathic pulmonary fibrosis (IPF), although the directionality of the relationship has been debated. Data on the value of objective reflux measures in predicting IPF disease progression and mortality remain limited. We aimed to evaluate the association between multichannel intraluminal impedance and pH testing (MII\u2010pH) and 3\u2010year pulmonary outcomes in IPF patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study of adults with IPF who underwent pre\u2010lung transplant MII\u2010pH off acid suppression at a tertiary center. Patients were followed for 3\u00a0years after MII\u2010pH for poor pulmonary outcomes (hospitalization for respiratory exacerbation or death). A secondary analysis was performed using mortality as outcome of interest. Time\u2010to\u2010event analyses using Kaplan\u2013Meier and Cox regression were performed to evaluate associations between MII\u2010pH and poor outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred twenty\u2010four subjects (mean age\u00a0=\u00a061.7\u00a0\u00b1\u00a08\u00a0years, 62% male) were included. Increased bolus exposure time (BET) on MII\u2010pH was associated with decreased time to poor pulmonary outcomes and death (log\u2010ranked <jats:italic>P<\/jats:italic>\u2010value\u00a0=\u00a00.017 and 0.031, respectively). On multivariable Cox regression analyses controlling for potential confounders including age, sex, smoking history, body mass index, proton pump inhibitor use, baseline pulmonary function, and anti\u2010fibrotic therapy, increased BET was an independent predictor for poor pulmonary outcomes [hazard ratio 3.18 (95% confidence interval: 1.25\u20138.09), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.015] and mortality [hazard ratio 11.3 (95% confidence interval: 1.37\u201363.9), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.025] over 3\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Increased BET on MII\u2010pH is an independent predictor of poor pulmonary outcomes and mortality over 3\u00a0years in IPF patients. These findings also support a role for gastroesophageal reflux in IPF disease progression and the potential impact of routine reflux testing and treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.16325","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T08:17:49Z","timestamp":1692692269000},"page":"1998-2005","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Abnormal bolus reflux on impedance\u2010pH testing independently predicts 3\u2010year pulmonary outcome and mortality in pulmonary fibrosis"],"prefix":"10.1111","volume":"38","author":[{"given":"Mariel E","family":"Bailey","sequence":"first","affiliation":[{"name":"Department of Medicine Brigham and Women's Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence 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USA"},{"name":"Division of Gastroenterology, Hepatology and Endoscopy Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sravanya","family":"Gavini","sequence":"additional","affiliation":[{"name":"Department of Medicine Brigham and Women's Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Gastroenterology, Hepatology and Endoscopy Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai\u2010Kit","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Medicine Brigham and Women's Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Gastroenterology, Hepatology and Endoscopy Brigham and Women's Hospital  Boston Massachusetts 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