Low income and progression free survival in idiopathic pulmonary fibrosis: An association to uncover - 09/06/21
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Résumé |
Background |
Low income is a known prognostic indicator of various chronic respiratory diseases but has not been studied in idiopathic pulmonary fibrosis (IPF). We hypothesize that a low income has an adverse prognostic impact on IPF.
Methods |
Patients were selected from the French national prospective cohort COFI. Patient's income was assessed through the median city-level income provided by the French National Institute of Statistics and Economic Studies according to his/her residential address. Patients were classified in two groups as “low income” vs. “higher income” depending on whether their annual city-level income was estimated to be<or ≥18 170 €/year (the first quartile of the income distribution in the study population). The overall survival and progression-free survival (PFS) of the groups were compared by a log-rank test and a Cox model in multivariate analysis.
Results |
200 patients were included. The average follow-up was 33.8±22.7 months. Patients in the low income group were more likely to be of non-European origin (42 vs. 17%, P<0.006), to have an occupational exposure (46 vs. 20%, P<0.0001), and a higher cumulative exposure to fine particles (PM2.5: 20.4±3.6 vs. 19±3.0μg/m3(P=0.057)). After adjusting for age, gender and forced vital capacity (FVC) at inclusion, having a low-income level remained a factor associated with a worse PFS (HR: 1.49 (95% CI: 1.05-2.10), P=0.025) but no difference in overall survival was observed.
Conclusions |
Low income appears to be a prognostic factor of progression free survival in IPF. And patients with low incomes may also be exposed more frequently to occupational exposures and to higher cumulative exposure to fine particles.
Le texte complet de cet article est disponible en PDF.Keywords : Idiopathic pulmonary fibrosis, Occupation, Social support
Plan
Vol 38 - N° 6
P. 587-588 - juin 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.