Evidence map›Paper›PMID 32605574›Full record

ArticleRespiratory research2020

Acute exacerbations of COPD versus IPF in patients with combined pulmonary fibrosis and emphysema.

Massa Zantah, Yaniv Dotan, Chandra Dass, Hauqing Zhao, Nathaniel Marchetti, Gerard J Criner

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

Article in Respiratory research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
5.7field-weighted citation impact, top 3% 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

23 citing papers in PubMed, 1 synthesis or guideline pooled it, 65 citations in OpenAlex.

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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

6 authors at 2 institutions in 1 country.

Massa ZantahDepartments of Thoracic Medicine and Surgery, the Lewis Katz School of Medicine at Temple University, 3401 North Broad Street, Philadelphia, PA, 19140, USA. massa.zantah@tuhs.temple.edu.ORCID http://orcid.org/0000-0002-3030-6639
Yaniv DotanDepartment of Pulmonary and Critical Care at St. Luke's University Health Network, Philadelphia, PA, 18015, USA.
Chandra DassDepartments of Radiology, the Lewis Katz School of Medicine at Temple University, Philadelphia, PA, 19140, USA.
Hauqing ZhaoDepartments of Biostatistics, the Lewis Katz School of Medicine at Temple University, Philadelphia, PA, 19140, USA.
Nathaniel MarchettiDepartments of Thoracic Medicine and Surgery, the Lewis Katz School of Medicine at Temple University, 3401 North Broad Street, Philadelphia, PA, 19140, USA.
Gerard J CrinerDepartments of Thoracic Medicine and Surgery, the Lewis Katz School of Medicine at Temple University, 3401 North Broad Street, Philadelphia, PA, 19140, USA.
Temple University · USSt. Luke's University Health Network · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

rationalePatients with combined pulmonary fibrosis and emphysema (CPFE) may develop acute exacerbations of IPF (AE-IPF) or COPD (AE-COPD). The incidence and the characteristics of exacerbations in patients with CPFE (e.g., COPD vs IPF) have not been well described.

objectivesTo compare the incidence and rate of exacerbations in patients with CPFE vs. IPF and evaluate their effect on clinical outcomes.

methodsComprehensive clinical data from CPFE and IPF patients were retrospectively reviewed. Baseline characteristics including lung function data, oxygen requirements, and pulmonary hemodynamics, were collected. Acute exacerbation events in both groups were defined clinically and radiographically. In the CPFE group, two patterns of exacerbations were identified. AE-COPD was defined clinically by symptoms of severe airflow obstruction causing respiratory failure and requiring hospitalization. Radiographic data were also defined based on previously published literature. AE-IPF was defined clinically as an acute hypoxic respiratory failure, requiring hospitalization and treatment with high dose corticosteroids. Radiographically, patients had to have a change in baseline imaging including presence of ground-glass opacities, interlobular septal thickening or new consolidations; that is not fully explained by other etiologies.

resultsEighty-five CPFE patients were retrospectively compared to 112 IPF patients. Of 112 patients with IPF; 45 had AE-IPF preceding lung transplant (40.18%) compared to 12 patients in the CPFE group (14.1%) (p < 0.05). 10 patients in the CPFE group experienced AE-COPD (11.7%). Patients with AE-IPF had higher mortality and more likely required mechanical ventilation and extracorporeal membrane oxygenation (ECMO) compared to patients with AE-COPD, whether their underlying disease was IPF or CPFE.

conclusionsCPFE patients may experience either AE-IPF or AE-COPD. Patients with CPFE and AE-COPD had better outcomes, requiring less intensive therapy compared to patients with AE-IPF regardless if underlying CPFE or IPF was present. These data suggest that the type of acute exacerbation, AE-COPD vs AE-IPF, has important implications for the treatment and prognosis of patients with CPFE.

Indexed as

Adrenal Cortex HormonesAgedAged, 80 and overAirway ObstructionExtracorporeal Membrane OxygenationFemaleHumansIdiopathic Pulmonary FibrosisIncidenceMaleMiddle AgedPulmonary Disease, Chronic ObstructivePulmonary EmphysemaPulmonary FibrosisRespiration, ArtificialRespiratory Function TestsAdrenal Cortex HormonesAcute exacerbationCombined pulmonary fibrosis and emphysemaCOPDIPF

Identifiers

PMID32605574
PMCPMC7325151
OpenAlexW3039054896

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.