Division of Allergy and Respiratory Diseases, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.
Department of Data Science, Hanmi Pharm. Co., Ltd, Seoul, Republic of Korea.
Respir Res. 2024 Apr 29;25(1):191. doi: 10.1186/s12931-024-02819-w.
Smoking status has been linked to the development of idiopathic pulmonary fibrosis (IPF). However, the effect of smoking on the prognosis of patients with IPF is unclear. We aimed to investigate the association between smoking status and all-cause mortality or hospitalisation by using national health claims data.
IPF cases were defined as people who visited medical institutions between January 2002 and December 2018 with IPF and rare incurable disease exempted calculation codes from the National Health Insurance Database. Total 10,182 patients with available data on smoking status were included in this study. Ever-smoking status was assigned to individuals with a history of smoking ≥ 6 pack-years. The multivariable Cox proportional hazard model was used to evaluate the association between smoking status and prognosis.
In the entire cohort, the mean age was 69.4 years, 73.9% were males, and 45.2% were ever smokers (current smokers: 14.2%; former smokers: 31.0%). Current smokers (hazard ratio [HR]: 0.709; 95% confidence interval [CI]: 0.643-0.782) and former smokers (HR: 0.926; 95% CI: 0.862-0.996) were independently associated with all-cause mortality compared with non-smokers. Current smokers (HR: 0.884; 95% CI: 0.827-0.945) and former smokers (HR: 0.909; 95% CI: 0.862-0.959) were also associated with a reduced risk of all-cause hospitalisation compared with non-smokers. A non-linear association between smoking amount and prognosis was found in a spline HR curve and showed increasing risk below 6 pack-years.
Ever-smoking status may be associated with favourable clinical outcomes in patients with IPF.
吸烟状况与特发性肺纤维化（IPF）的发生有关。然而，吸烟对 IPF 患者预后的影响尚不清楚。本研究旨在利用国家健康保险索赔数据，调查吸烟状况与全因死亡率或住院治疗之间的关联。
IPF 病例定义为 2002 年 1 月至 2018 年 12 月期间因 IPF 和罕见不可治愈疾病在医疗机构就诊且不计入国家健康保险数据库的豁免计算代码的人群。本研究共纳入 10182 例有吸烟状况数据的患者。有吸烟史者被定义为吸烟量≥6 包年。多变量 Cox 比例风险模型用于评估吸烟状况与预后之间的关系。
在整个队列中，患者的平均年龄为 69.4 岁，73.9%为男性，45.2%为有吸烟史者（当前吸烟者：14.2%；曾经吸烟者：31.0%）。与从不吸烟者相比，当前吸烟者（风险比[HR]：0.709；95%置信区间[CI]：0.643-0.782）和曾经吸烟者（HR：0.926；95% CI：0.862-0.996）与全因死亡率独立相关。与从不吸烟者相比，当前吸烟者（HR：0.884；95% CI：0.827-0.945）和曾经吸烟者（HR：0.909；95% CI：0.862-0.959）也与全因住院风险降低相关。在 Spline HR 曲线中发现吸烟量与预后之间存在非线性关联，且在 6 包年以下吸烟量与风险增加相关。
有吸烟史可能与 IPF 患者的有利临床结局相关。
