Nocturnal Hypoxemia Associates With Symptom Progression and Mortality in Patients With Progressive Fibrotic Interstitial Lung Disease.

Autor:	Myall KJ; Guy's and St Thomas' NHS Foundation Trust, London, England. Electronic address: katherinejane.myall@nhs.net., West AG; Guy's and St Thomas' NHS Foundation Trust, London, England., Martinovic JL; Guy's and St Thomas' NHS Foundation Trust, London, England., Lam JL; Guy's and St Thomas' NHS Foundation Trust, London, England., Roque D; Guy's and St Thomas' NHS Foundation Trust, London, England., Wu Z; Royal Brompton and Harefield NHS Foundation Trust, London, England., Maher TM; Royal Brompton and Harefield NHS Foundation Trust, London, England., Molyneaux PL; Royal Brompton and Harefield NHS Foundation Trust, London, England., Suh ES; Lane Fox Respiratory Unit, St Thomas' Hospital, London, England., Kent BD; St James's Hospital, Dublin, Ireland.
Jazyk:	angličtina
Zdroj:	Chest [Chest] 2023 Nov; Vol. 164 (5), pp. 1232-1242. Date of Electronic Publication: 2023 May 13.
DOI:	10.1016/j.chest.2023.05.013
Abstrakt:	Background: OSA and nocturnal hypoxemia (NH) are common in patients with fibrotic interstitial lung disease (F-ILD), but their relationship with disease outcomes remains unclear. Research Question: What is the relationship between NH and OSA and clinical outcomes in patients with F-ILD? Study Design and Methods: This was a prospective observational cohort study of patients with F-ILD and without daytime hypoxemia. Patients underwent home sleep study at baseline and were followed up for at least 1 year or until death. NH was defined as ≥ 10% of sleep with oxygen saturation of < 90%. OSA was defined as an apnea-hypopnea index of ≥ 15 events/h. Results: Among 102 participants (male, 74.5%; age, 73.0 ± 8.7 years; FVC, 2.74 ± 0.78 L; 91.1% idiopathic pulmonary fibrosis), 20 patients (19.6%) demonstrated prolonged NH and 32 patients (31.4%) showed OSA. No significant differences were found between those with and without NH or OSA at baseline. Despite this, NH was associated with a more rapid decline in both quality of life as measured by the King's Brief Interstitial Lung Disease questionnaire (change, -11.3 ± 5.3 points in the NH group vs -6.7 ± 6.5 in those without NH; P = .005) and higher all-cause mortality at 1 year (hazard ratio, 8.21; 95% CI, 2.40-28.1; P < .001). No statistically significant difference was seen between the groups in annualized change in measures of pulmonary function testing. Interpretation: Prolonged NH, but not OSA, is associated with worsening disease-related quality of life and increased mortality in patients with F-ILD. (Copyright © 2023 American College of Chest Physicians. All rights reserved.)
Databáze:	MEDLINE
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