Veit Tobias, Barnikel Michaela, Kneidinger Nikolaus, Munker Dieter, Arnold Paola, Barton Jürgen, Crispin Alexander, Milger Katrin, Behr Jürgen, Neurohr Claus, Leuschner Gabriela
Department of Internal Medicine V, Ludwig-Maximilian University Munich, 81377 Munich, Germany.
Comprehensive Pneumology Center (CPC-M), German Center for Lung Research, 81377 Munich, Germany.
J Clin Med. 2023 May 31;12(11):3787. doi: 10.3390/jcm12113787.
Physical activity limitations and cough are common in patients with interstitial lung disease (ILD), potentially leading to reduced health-related quality of life. We aimed to compare physical activity and cough between patients with subjective, progressive idiopathic pulmonary fibrosis (IPF) and fibrotic non-IPF ILD. In this prospective observational study, wrist accelerometers were worn for seven consecutive days to track steps per day (SPD). Cough was evaluated using a visual analog scale (VAS) at baseline and weekly for six months. We included 35 patients (IPF: = 13; non-IPF: = 22; mean ± SD age 61.8 ± 10.8 years; FVC 65.3 ± 21.7% predicted). Baseline mean ± SD SPD was 5008 ± 4234, with no differences between IPF and non-IPF ILD. At baseline, cough was reported by 94.3% patients (mean ± SD VAS 3.3 ± 2.6). Compared to non-IPF ILD, patients with IPF had significantly higher burden of cough ( = 0.020), and experienced a greater increase in cough over six months ( = 0.009). Patients who died or underwent lung transplantation ( = 5), had significantly lower SPD ( = 0.007) and higher VAS ( = 0.047). Long-term follow up identified VAS (HR: 1.387; 95%-CI 1.081-1.781; = 0.010) and SPD (per 1000 SPD: HR 0.606; 95%-CI: 0.412-0.892; = 0.011) as significant predictors for transplant-free survival. In conclusion, although activity didn't differ between IPF and non-IPF ILD, cough burden was significantly greater in IPF. SPD and VAS differed significantly in patients who subsequently experienced disease progression and were associated with long-term transplant-free survival, calling for better acknowledgement of both parameters in disease management.
身体活动受限和咳嗽在间质性肺疾病（ILD）患者中很常见，这可能会导致与健康相关的生活质量下降。我们旨在比较主观、进行性特发性肺纤维化（IPF）患者和纤维化非IPF-ILD患者之间的身体活动和咳嗽情况。在这项前瞻性观察研究中，连续七天佩戴腕部加速度计以追踪每日步数（SPD）。在基线时以及六个月内每周使用视觉模拟量表（VAS）评估咳嗽情况。我们纳入了35例患者（IPF：n = 13；非IPF：n = 22；平均±标准差年龄61.8±10.8岁；预测FVC为65.3±21.7%）。基线时平均±标准差SPD为5008±4234，IPF和非IPF-ILD之间无差异。在基线时，94.3%的患者报告有咳嗽（平均±标准差VAS为3.3±2.6）。与非IPF-ILD相比，IPF患者的咳嗽负担显著更高（P = 0.020），并且在六个月内咳嗽增加得更多（P = 0.009）。死亡或接受肺移植的患者（n = 5），SPD显著更低（P = 0.007），VAS更高（P = 0.047）。长期随访确定VAS（HR：1.387；95%置信区间1.081 - 1.781；P = 0.010）和SPD（每1000 SPD：HR 0.606；95%置信区间：0.412 - 0.892；P = 0.011）是无移植生存的重要预测因素。总之，虽然IPF和非IPF-ILD之间的活动没有差异，但IPF的咳嗽负担显著更大。SPD和VAS在随后经历疾病进展的患者中差异显著，并且与长期无移植生存相关，这就要求在疾病管理中更好地认识这两个参数。
