{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:19:12Z","timestamp":1791908352741,"version":"4.3.4"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T00:00:00Z","timestamp":1641945600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and objective<\/jats:title><jats:p>A proportion of patients with fibrotic hypersensitivity pneumonitis (fHP) follow a progressive disease course despite immunosuppressive treatment. Little is known about predictors of mortality in fHP. We aimed to investigate the impact of short\u2010term lung function changes in fHP on mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Baseline demographics for 145 consecutive patients with a multi\u2010disciplinary team diagnosis of fHP, as well as baseline and 1\u2010year follow\u2010up of lung function, baseline echocardiographic findings, bronchoalveolar lavage (BAL) cellularity and all\u2010cause mortality were recorded. Changes in forced vital capacity (FVC)\u2009\u2265\u20095% and \u226510%, and diffusion capacity of the lung for carbon monoxide (DLCO)\u2009\u2265\u200910% and \u226515% at 1\u2009year were calculated. Cox proportional hazards analysis was performed to test for associations with mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline lung function severity, age, presence of honeycombing on computed tomography (CT) and echocardiographic pulmonary arterial systolic pressure (PASP)\u2009\u2265\u200940\u2009mm Hg were associated with early mortality, while BAL lymphocytosis was associated with improved survival. A decline in FVC\u2009\u2265\u20095% (hazard ratio [HR]: 3.10, 95% CI: 2.00\u20134.81, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001), FVC\u2009\u2265\u200910% (HR: 3.11, 95% CI: 1.94\u20134.99, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001), DLCO\u2009\u2265\u200910% (HR: 2.80, 95% CI: 1.78\u20134.42, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001) and DLCO\u2009\u2265\u200915% (HR: 2.92, 95% CI: 1.18\u20134.72, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001) at 1\u2009year was associated with markedly reduced survival on univariable and multivariable analyses after correcting for demographic variables, disease severity, honeycombing on CT and treatment, as well as BAL lymphocytosis and PASP\u2009\u2265\u200940\u2009mm Hg on echocardiography, in separate models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Worsening in FVC and DLCO at 1\u2009year, including a marginal decline in FVC\u2009\u2265\u20095% and DLCO\u2009\u2265\u200910%, is predictive of markedly reduced survival in fHP.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.14204","type":"journal-article","created":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T02:24:11Z","timestamp":1642040651000},"page":"202-208","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Short\u2010term lung function changes predict mortality in patients with fibrotic hypersensitivity pneumonitis"],"prefix":"10.1111","volume":"27","author":[{"given":"Claudio","family":"Macaluso","sequence":"first","affiliation":[{"name":"Interstitial Lung Disease Unit Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust  London UK"},{"name":"Department of Pneumology INRCA\/IRCCS, \"L.Mandic\" Hospital Merate (LC)  Merate Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Boccabella","sequence":"additional","affiliation":[{"name":"Interstitial Lung Disease Unit Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust  London UK"},{"name":"Department of Medical and Surgical Sciences Fondazione Policlinico Universitario \"A. Gemelli\" \u2013 IRCCS, University of the Sacred Heart  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Kokosi","sequence":"additional","affiliation":[{"name":"Interstitial Lung Disease Unit Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishanth","family":"Sivarasan","sequence":"additional","affiliation":[{"name":"Department of Radiology Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasilis","family":"Kouranos","sequence":"additional","affiliation":[{"name":"Interstitial Lung Disease Unit Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M.","family":"George","sequence":"additional","affiliation":[{"name":"Interstitial Lung Disease Unit Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust  London UK"},{"name":"Margaret Turner Warwick Centre for Fibrosing Lung Disease National Heart and Lung Institute, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Margaritopoulos","sequence":"additional","affiliation":[{"name":"Interstitial Lung Disease Unit Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust  London UK"},{"name":"ILD Unit London North West University Hospital Healthcare Trust  London UK"},{"name":"Faculty of Biology, Medicine and Health The University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip L.","family":"Molyneaux","sequence":"additional","affiliation":[{"name":"Interstitial Lung Disease Unit Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust  London UK"},{"name":"Margaret Turner Warwick Centre for Fibrosing Lung Disease National Heart and Lung Institute, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7845-0173","authenticated-orcid":false,"given":"Felix","family":"Chua","sequence":"additional","affiliation":[{"name":"Interstitial Lung Disease Unit Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7192-9149","authenticated-orcid":false,"given":"Toby M.","family":"Maher","sequence":"additional","affiliation":[{"name":"Interstitial Lung Disease Unit Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust  London UK"},{"name":"Margaret Turner Warwick Centre for Fibrosing Lung Disease National Heart and Lung Institute, Imperial College London  London UK"},{"name":"Hastings Centre for Pulmonary Research and Division of Pulmonary, Critical Care and Sleep Medicine Keck School of Medicine, University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisli R.","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Interstitial Lung Disease Unit Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust  London UK"},{"name":"Margaret Turner Warwick Centre for Fibrosing Lung Disease National Heart and Lung Institute, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew G.","family":"Nicholson","sequence":"additional","affiliation":[{"name":"Margaret Turner Warwick Centre for Fibrosing Lung Disease National Heart and Lung Institute, Imperial College London  London UK"},{"name":"Department of Histopathology Royal Brompton and Harefield 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