ABSTRACT
Background
Hypersensitivity pneumonitis (HP) related deaths have increased substantially in recent years. It is important to identify the risk factors of HP significantly associated with mortality to ensure close patient monitoring and assess disease progression.
Research design and methods
Extensive literature search was conducted in accordance with the PRISMA checklist. Literature search of PubMed, Embase, and Cochrane Library database between January 2009 and April 2021 using the terms ‘hypersensitivity pneumonitis’, ‘hazard ratio’, and ‘mortality’ identified 325 articles. A total of 22 independent original studies focusing on mortality of HP patients were assessed.
Results
This systematic review and meta-analysis suggests that increased age, male sex, honeycombing, and traction bronchiectasis patterns on high-resolution computed tomography (HRCT) images are the major mortality-related risk factors of patients with HP. In case of chronic HP, antigen exposure appeared to be an additional risk factor.
Conclusions
The clinico-radiological risk factors of mortality identified for HP will enable effective and close monitoring of patients, prognostication, and guide toward appropriate management decisions. However, association between the type of antigen and mortality remains to be explored.
Abbreviations
DLco | = | Diffusing capacity for carbon monoxide |
DPLD | = | Diffuse parenchymal lung disease |
FVC | = | Forced vital capacity |
GGO | = | Ground glass opacity |
HP | = | Hypersensitivity pneumonitis |
HRCT | = | High-resolution computed tomography |
IPF | = | Idiopathic pulmonary fibrosis |
OR | = | Odds ratio |
Acknowledgments
S Dasgupta and A Bhattacharya acknowledge the Ministry of Human Resource and Development, India, and Indian Institute of Technology Kharagpur for research fellowship.
Declaration of Interest
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties
Reviewer Disclosures
Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.
Author contributions
S Dasgupta has full access to all data used in the study and takes responsibility for the integrity and accuracy of the data. S Dasgupta, A Bhattacharya, and D Rajwade conducted literature search, extracted the results, performed the meta-analysis; and drafted the manuscript. S Roy Chowdhury and K Chaudhury revised the manuscript.
Supplementary material
Supplemental data for this article can be accessed online at https://doi.org/10.1080/17476348.2022.2100352