Use of peripheral neutrophil to lymphocyte ratio and peripheral monocyte levels to predict survival in fibrotic hypersensitivity pneumonitis (fHP): a multicentre retrospective cohort study

Methods A retrospective, multicentre, observational UK cohort study.Results Patients with fHP were significantly younger than those with idiopathic pulmonary fibrosis (IPF) (median age fHP 73 vs IPF 75 years) and were much more likely to be woman (fHP 61% vs IPF 26%). In almost half of all fHP cases...

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Main Authors: Andrew W Creamer, Shaney L Barratt, Huzaifa I Adamali, Michael Gibbons, Bibek Gooptu, Anna Duckworth, Rebecca Wollerton, Chris Scotton, Janet Fallon, Matthew Steward, Silan Fidan, Tom Nancarrow, Felix Alexander Woodhead
Format: Article
Language:English
Published: BMJ Publishing Group 2021-01-01
Series:BMJ Open Respiratory Research
Online Access:https://bmjopenrespres.bmj.com/content/8/1/e001063.full
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author Andrew W Creamer
Shaney L Barratt
Huzaifa I Adamali
Michael Gibbons
Bibek Gooptu
Anna Duckworth
Rebecca Wollerton
Chris Scotton
Janet Fallon
Matthew Steward
Silan Fidan
Tom Nancarrow
Felix Alexander Woodhead
author_facet Andrew W Creamer
Shaney L Barratt
Huzaifa I Adamali
Michael Gibbons
Bibek Gooptu
Anna Duckworth
Rebecca Wollerton
Chris Scotton
Janet Fallon
Matthew Steward
Silan Fidan
Tom Nancarrow
Felix Alexander Woodhead
author_sort Andrew W Creamer
collection DOAJ
description Methods A retrospective, multicentre, observational UK cohort study.Results Patients with fHP were significantly younger than those with idiopathic pulmonary fibrosis (IPF) (median age fHP 73 vs IPF 75 years) and were much more likely to be woman (fHP 61% vs IPF 26%). In almost half of all fHP cases (49%, n=104/211), no causative antigen was identified from either the history or specific antigen testing. Overall, fHP was associated with a better survival than IPF, although median survival of both groups was poor (fHP 62 months vs IPF 52 months).IPF survival in patients with a high NLR was significantly lower than those with a low NLR (44 vs 83 months). A monocyte count ≥0.95 K/uL also predicted significantly poorer outcomes for patients with IPF compared with <0.95 K/uL (33 vs 57 months). In contrast, NLR and monocyte count did not predict survival in the fHP cohort.Conclusions Although fHP has a statistically lower mortality than IPF, absolute survival time of both conditions is poor. High baseline NLR and absolute monocyte counts predict worse survival in IPF but not in fHP, highlighting the potential for divergence in their pathogenic mechanisms.
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spelling doaj-art-40a4f284be5f4574b66a95f0791911a32024-11-24T22:40:08ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392021-01-018110.1136/bmjresp-2021-001063Use of peripheral neutrophil to lymphocyte ratio and peripheral monocyte levels to predict survival in fibrotic hypersensitivity pneumonitis (fHP): a multicentre retrospective cohort studyAndrew W Creamer0Shaney L Barratt1Huzaifa I Adamali2Michael Gibbons3Bibek Gooptu4Anna Duckworth5Rebecca Wollerton6Chris Scotton7Janet Fallon8Matthew Steward9Silan Fidan10Tom Nancarrow11Felix Alexander Woodhead12Lungs for Living Research Centre, UCL Respiratory, University College London, London, UKBristol Interstitial Lung Disease Service, North Bristol NHS Trust, Bristol, UKBristol Interstitial Lung Disease Service, North Bristol NHS Trust, Bristol, UKRespiratory Medicine, Royal Devon & Exeter NHS Foundation Trust, Exeter, UK19 London Alpha-1 Antitrypsin Deficiency Service, Royal Free Hospital, London, UKAcademic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation Trust, Exeter, UKDepartment of Respiratory Medicine, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UKAcademic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation Trust, Exeter, UKDepartment of Respiratory Medicine, Somerset Lung Centre, Musgrove Park Hospital, Taunton, UKDepartment of Respiratory Medicine, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UKDepartment of Respiratory Medicine, Institute for Lung Health, Leicester, UKDepartment of Respiratory Medicine, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UKDepartment of Respiratory Medicine, Institute for Lung Health, Leicester, UKMethods A retrospective, multicentre, observational UK cohort study.Results Patients with fHP were significantly younger than those with idiopathic pulmonary fibrosis (IPF) (median age fHP 73 vs IPF 75 years) and were much more likely to be woman (fHP 61% vs IPF 26%). In almost half of all fHP cases (49%, n=104/211), no causative antigen was identified from either the history or specific antigen testing. Overall, fHP was associated with a better survival than IPF, although median survival of both groups was poor (fHP 62 months vs IPF 52 months).IPF survival in patients with a high NLR was significantly lower than those with a low NLR (44 vs 83 months). A monocyte count ≥0.95 K/uL also predicted significantly poorer outcomes for patients with IPF compared with <0.95 K/uL (33 vs 57 months). In contrast, NLR and monocyte count did not predict survival in the fHP cohort.Conclusions Although fHP has a statistically lower mortality than IPF, absolute survival time of both conditions is poor. High baseline NLR and absolute monocyte counts predict worse survival in IPF but not in fHP, highlighting the potential for divergence in their pathogenic mechanisms.https://bmjopenrespres.bmj.com/content/8/1/e001063.full
spellingShingle Andrew W Creamer
Shaney L Barratt
Huzaifa I Adamali
Michael Gibbons
Bibek Gooptu
Anna Duckworth
Rebecca Wollerton
Chris Scotton
Janet Fallon
Matthew Steward
Silan Fidan
Tom Nancarrow
Felix Alexander Woodhead
Use of peripheral neutrophil to lymphocyte ratio and peripheral monocyte levels to predict survival in fibrotic hypersensitivity pneumonitis (fHP): a multicentre retrospective cohort study
BMJ Open Respiratory Research
title Use of peripheral neutrophil to lymphocyte ratio and peripheral monocyte levels to predict survival in fibrotic hypersensitivity pneumonitis (fHP): a multicentre retrospective cohort study
title_full Use of peripheral neutrophil to lymphocyte ratio and peripheral monocyte levels to predict survival in fibrotic hypersensitivity pneumonitis (fHP): a multicentre retrospective cohort study
title_fullStr Use of peripheral neutrophil to lymphocyte ratio and peripheral monocyte levels to predict survival in fibrotic hypersensitivity pneumonitis (fHP): a multicentre retrospective cohort study
title_full_unstemmed Use of peripheral neutrophil to lymphocyte ratio and peripheral monocyte levels to predict survival in fibrotic hypersensitivity pneumonitis (fHP): a multicentre retrospective cohort study
title_short Use of peripheral neutrophil to lymphocyte ratio and peripheral monocyte levels to predict survival in fibrotic hypersensitivity pneumonitis (fHP): a multicentre retrospective cohort study
title_sort use of peripheral neutrophil to lymphocyte ratio and peripheral monocyte levels to predict survival in fibrotic hypersensitivity pneumonitis fhp a multicentre retrospective cohort study
url https://bmjopenrespres.bmj.com/content/8/1/e001063.full
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