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Functional ageing in fibrotic interstitial lung disease: the impact of frailty on adverse health outcomes.

纤维化间质性肺病的功能老化: 虚弱对不良健康结局的影响。

  • 影响因子:4.82
  • DOI:10.1183/13993003.00647-2019
  • 作者列表:"Guler SA","Kwan JM","Leung JM","Khalil N","Wilcox PG","Ryerson CJ
  • 发表时间:2020-01-23
Abstract

BACKGROUND:Accelerated biological and functional ageing is common in fibrotic interstitial lung disease (ILD); however, their impact on adverse health outcomes has not been evaluated in this population. METHODS:Patients were prospectively recruited from a specialised ILD clinic. Functional ageing was determined by frailty index and biological age by measurement of absolute telomere length (aTL) from patients' peripheral blood leukocytes. Adverse health outcomes included health-related quality of life (St George's Respiratory Questionnaire), number and length of respiratory and non-respiratory hospitalisations, medication tolerability and time to death or lung transplantation. Multivariable models were used to determine the risks and rates of adverse health outcomes associated with the frailty index and aTL. RESULTS:540 patients with fibrotic ILD, including 100 with idiopathic pulmonary fibrosis (IPF), provided 749 frailty index assessments, with 189 patients providing blood samples. The frailty index was strongly associated with quality of life, rate of hospitalisation, time to hospital discharge and mortality, including adjustment for age, sex, disease severity and IPF diagnosis. Mortality prognostication was improved by the addition of the frailty index to commonly used clinical parameters and previously validated composite indices. Conversely, aTL was not associated with most adverse health outcomes. The effect of chronological age on outcomes was mediated primarily by the frailty index, and to a lesser extent by aTL. CONCLUSIONS:Functional ageing is associated with adverse health outcomes in patients with fibrotic ILD, indicating the need for consideration of the individual functional age into clinical decision-making.

摘要

背景: 加速生物学和功能老化在纤维化间质性肺病 (ILD) 中很常见; 然而,它们对不良健康结局的影响尚未在该人群中评估。 方法: 从专门的 ILD 诊所前瞻性招募患者。通过测量患者外周血白细胞的绝对端粒长度 (aTL),通过虚弱指数和生物年龄确定功能衰老。不良健康结局包括健康相关生活质量 (圣乔治呼吸问卷) 、呼吸和非呼吸系统住院次数和时间、药物耐受性和死亡或肺移植时间。使用多变量模型确定与虚弱指数和 aTL 相关的不良健康结局的风险和发生率。 结果: 540 例纤维化 ILD 患者,包括 100 例特发性肺纤维化 (IPF) 患者,提供了 749 个虚弱指数评估,189 例患者提供了血液样本。虚弱指数与生活质量、住院率、出院时间和死亡率密切相关,包括调整年龄、性别、疾病严重程度和 IPF 诊断。通过将虚弱指数添加到常用的临床参数和先前验证的综合指数中,死亡率预测得到改善。相反,aTL 与大多数不良健康结局无关。实足年龄对结局的影响主要由虚弱指数介导,较小程度上由 aTL 介导。 结论: 功能性老化与纤维化 ILD 患者的不良健康结局相关,表明需要在临床决策中考虑个体功能年龄。

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翻译标题与摘要 下载文献
影响因子:4.40
发表时间:2020-01-01
DOI:10.1007/s00262-019-02431-8
作者列表:["Shibaki, Ryota","Murakami, Shuji","Matsumoto, Yuji","Yoshida, Tatsuya","Goto, Yasushi","Kanda, Shintaro","Horinouchi, Hidehito","Fujiwara, Yutaka","Yamamoto, Nobuyuki","Kusumoto, Masahiko","Yamamoto, Noboru","Ohe, Yuichiro"]

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翻译标题与摘要 下载文献
影响因子:4.04
发表时间:2020-01-25
来源期刊:New biotechnology
DOI:10.1016/j.nbt.2019.08.006
作者列表:["Sousa SA","Soares-Castro P","Seixas AMM","Feliciano JR","Balugas B","Barreto C","Pereira L","Santos PM","Leitão JH"]

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