Evidence map›Paper›PMID 27023440›Full record

ArticlePloS one2016

Impact of Comorbidities on Mortality in Patients with Idiopathic Pulmonary Fibrosis.

Michael Kreuter, Svenja Ehlers-Tenenbaum, Karin Palmowski, Jacques Bruhwyler, Ute Oltmanns, Thomas Muley, Claus Peter Heussel, Arne Warth, Martin Kolb, Felix J F Herth

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 172 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
172citing papers in PubMed, 10 pooled it
27.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

172 citing papers in PubMed, 10 syntheses or guidelines pooled it, 341 citations in OpenAlex.

  1. Comorbidities in clinical cohorts of patients with idiopathic pulmonary fibrosis: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2026
    Pooled it
  2. Economic burden and cost drivers of interstitial lung disease: a systematic review.The European journal of health economics : HEPAC : health economics in prevention and care · 2026
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Guideline
  7. Health-related quality of life of patients with idiopathic pulmonary fibrosis: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2020
    Pooled it
  8. Prognosis of idiopathic pulmonary fibrosis without anti-fibrotic therapy: a systematic review.European respiratory review : an official journal of the European Respiratory Society · 2020
    Pooled it
  9. Pooled it
  10. Pooled it
  11. Trial
  12. Trial
  13. Trial
  14. Predicting Life Expectancy for Pirfenidone in Idiopathic Pulmonary Fibrosis.Journal of managed care & specialty pharmacy · 2017
    Trial
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  16. Article
  17. Article
  18. Review
  19. Article
  20. Article

112 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 3 countries.

Michael KreuterCentre for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
Svenja Ehlers-TenenbaumCentre for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
Karin PalmowskiCentre for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
Jacques BruhwylerECSOR Department of Biostatistics, Gembloux, Belgium.
Ute OltmannsCentre for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
Thomas MuleyDepartment of Translational Research, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
Claus Peter HeusselDiagnostic and Interventional Radiology, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
Arne WarthInstitute of Pathology, University of Heidelberg, Heidelberg, Germany.
Martin KolbMcMaster University, Hamilton, ON, Canada.
Felix J F HerthCentre for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
Heidelberg University · DEGerman Center for Lung Research · DEGembloux Agro-Bio Tech · BEMcMaster University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionComorbidities significantly influence the clinical course of idiopathic pulmonary fibrosis (IPF). However, their prognostic impact is not fully understood. We therefore aimed to determine the impact of comorbidities, as individual and as whole, on survival in IPF.

methodsThe database of a tertiary referral centre for interstitial lung diseases was reviewed for comorbidities, their treatments, their frequency and survival in IPF patients.

results272 patients were identified of which 12% had no, 58% 1-3 and 30% 4-7 comorbidities, mainly cardiovascular, pulmonary and oncologic comorbidities. Median survival according to the frequency of comorbidities differed significantly with 66 months for patients without comorbidities, 48 months when 1-3 comorbidities were reported and 35 months when 4-7 comorbidities were prevalent (p = 0.004). A multivariate Cox proportional hazard analyses identified other cardiac diseases and lung cancer as significant predictors of death, gastro-oesophageal reflux disease (GERD) and diastolic dysfunction had a significant positive impact on survival. A significant impact of comorbidities associated therapies on survival was not discovered. This included the use of proton pump inhibitors at baseline, which was not associated with a survival benefit (p = 0.718). We also established a predictive tool for highly prevalent comorbidities, termed IPF comorbidome which demonstrates a new relationship of IPF and comorbidities.

conclusionComorbidities are frequent in IPF patients. Some comorbidities, especially lung cancer, mainly influence survival in IPF, while others such as GERD may inherit a more favourable effect. Moreover, their cumulative incidence impacts survival.

Indexed as

ComorbidityAgedDemographyFemaleHumansIdiopathic Pulmonary FibrosisKaplan-Meier EstimateMaleProportional Hazards ModelsProton Pump InhibitorsSurvival AnalysisProton Pump Inhibitors

Identifiers

PMID27023440
PMCPMC4811578
OpenAlexW2328539250

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.