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Low income and progression free survival in idiopathic pulmonary fibrosis: An association to uncover - 09/06/21

Doi : 10.1016/j.rmr.2021.02.040 
L. Sese 1, , J. Caliez 2, I. Annesi-Maesano 3, V. Cottin 4, G. Pesce 3, M. Didier 2, Z. Carton 2, D. Israel-Biet 5, B. Crestani 6, S. Guillot Dudoret 7, J. Cadranel 8, B. Wallaert 9, A. Tazi 10, B. Maître 11, G. Prévot 12, S. Marchand-Adam 13, S. Hirschi 14, S. Dury 15, V. Giraud 16, A. Gondouin 17, P. Bonniaud 18, J. Traclet 4, K. Juvin 5, R. Borie 6, J.F. Bernaudin 2, D. Valeyre 2, C. Cavalin 19, H. Nunes 2
1 Assistance Publique–Hôpitaux de Paris (AP-HP), Service de Physiologie, Hôpital Avicenne, Bobigny, France 
2 Assistance Publique–Hôpitaux de Paris (AP-HP), Service de Pneumologie, Hôpital Avicenne, Bobigny, France 
3 EPAR, IPLESP UMR-S 1136, INSERM et Sorbonne Université Paris, France 
4 Service de Pneumologie, Hôpital Louis Pradel, Lyon, France 
5 AP-HP, Service de Pneumologie, Hôpital HEGP, Paris, France 
6 AP-HP, Service de Pneumologie, Hôpital Bichat, Paris, France 
7 Service de Pneumologie, Hôpital Pontchaillou, Rennes, France 
8 AP-HP, Service de Pneumologie, Hôpital Tenon, Paris, France 
9 Service de Pneumologie, Hôpital Albert Calmette, Lille, France 
10 AP-HP, Service de Pneumologie, Hôpital Saint-Louis, Paris, France 
11 AP-HP, Service de Pneumologie, Hôpital Henri-Mondor, Créteil, France 
12 Service de Pneumologie, Hôpital Larrey, Toulouse, France 
13 Service de Pneumologie, Hôpital Bretonneau, Tours, France 
14 Service de Pneumologie, Nouvel Hôpital Civil, Strasbourg, France 
15 Service de Pneumologie, Hôpital Maison Blanche, Reims, France 
16 AP-HP, Service de Pneumologie, Hôpital Ambroise Paré, Boulogne, France 
17 Service de Pneumologie, Hôpital Jean Minjoz, Besançon, France 
18 Service de Pneumologie, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France 
19 IRISSO (UMR CNRS-INRA 7170-1427), Paris-Dauphine Université, PSL, Paris, France 

Corresponding author.

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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.

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Keywords : Idiopathic pulmonary fibrosis, Occupation, Social support


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© 2021  Publié par Elsevier Masson SAS.
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Vol 38 - N° 6

P. 587-588 - juin 2021 Retour au numéro
Article précédent Article précédent
  • Socioeconomic status of patients hospitalized for COVID-19 in the Greater Paris area
  • L. Sesé, Y. Nguyen medical, E. Giroux Leprieur, I. Annesi-Maesano, C. Cavalin, J. Goupil de Bouillé, L. Demestier, R. Dhote, Y. Tandjaoui-Lambiotte, A. Bauvois, L. Teillet, S. Curac, S. Beaune, B. Duchemann, H. Nunes
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