BMC Pulmonary Medicine最新文献

{"title":"Incidence and prevalence of interstitial lung diseases in Norway: analysis of the national Norwegian patient registry.","authors":"Michael T Durheim, Phuong Phuong Diep, Sandre S Lirhus, Tomas M L Eagan","doi":"10.1186/s12890-026-04515-5","DOIUrl":"10.1186/s12890-026-04515-5","url":null,"abstract":"<p><strong>Background: </strong>Interstitial lung diseases (ILDs) are progressive chronic lung diseases associated with poor prognosis despite available disease-modifying therapy. Reported incidence and prevalence of ILD varies, and few studies have described epidemiology across the range of ILD subtypes in complete population-based cohorts. This study aimed to estimate incidence and prevalence of ILD, overall and by subtype, in a complete nationwide cohort from Norway.</p><p><strong>Methods: </strong>The Norwegian Patient Registry and Norwegian Prescribed Drug Registry were used to identify all patients with diagnosis codes identifying an ILD between 2011 and 2023. Using diagnosis code-based algorithms adapted from previous studies, the incidence and prevalence of ILD subtypes was estimated overall by year, and by subgroups defined by age and sex.</p><p><strong>Results: </strong>Using a broad definition, the overall prevalence of ILD in Norway has increased to over 450 cases per 100,000 from 2012 to 2023. The prevalence of idiopathic pulmonary fibrosis (IPF) has increased to 46 per 100,000 and prevalence of connective tissue disease related ILD (CTD-ILD) has increased to nearly 42 per 100,000. Current estimates of incidence ranged from about 1 per 100,000 for hypersensitivity pneumonitis, to about 5 per 100,000 for CTD-ILD, to 8-10 per 100,000 for IPF.</p><p><strong>Conclusions: </strong>Incidence and prevalence of ILDs in Norway are comparable to published reports from other regions. The prevalence of ILDs in Norway appears to be increasing substantially.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensity is in the eye of the beholder: a qualitative photovoice study of perceptions of physical activity intensity for people with chronic obstructive pulmonary disease.","authors":"Phoebe H I Lloyd-Evans, Dominic Malcolm, Sally J Singh, Alex V Rowlands, Emma Chaplin, Sarah Ward, Mark W Orme","doi":"10.1186/s12890-026-04520-8","DOIUrl":"10.1186/s12890-026-04520-8","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA)-related health benefits are greatest for activity undertaken at higher intensities. However, individuals living with Chronic Obstructive Pulmonary Disease (COPD) often find engaging in higher-intensity PA challenging. Due to the lack of qualitative research on how those with COPD perceive PA intensity, this photovoice study explores how PA intensity is experienced in day-to-day living.</p><p><strong>Methods: </strong>Semi-structured interviews, enhanced by photovoice, were conducted with individuals with COPD and other comorbidities to explore their perceptions of PA intensity in daily life. Participants captured images over 7 days to illustrate how their conditions impact their PA. The participant-generated images were used in the interviews. Reflexive inductive thematic analysis was used to generate themes.</p><p><strong>Results: </strong>Thirteen interviews were conducted (54% female, aged 64 ± 6 years), generating two main themes. Theme 1 focused on how individuals employ strategies to manage the intensity of their PA: breaking down PA, pacing themselves or trying to do the activity all in one go. Theme 2 highlighted the reciprocal relationship between participants and their family/friends regarding PA intensity. Family/friends often ensure individuals do not \"overdo it\" while participants may influence the intensity of their family/friends activities, sometimes requiring family/friends to slow down or stop.</p><p><strong>Conclusion: </strong>This study provides insights into the social complexities and strategies used to manage PA intensity in daily life, which can inform behavioural interventions to increase participation in higher-intensity PA among people with COPD.</p><p><strong>Trial registration: </strong>The study was retrospectively registered on Clinical Trials.gov (Identifier: NCT06330623) on the 26th of March 2024.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of experimental isolated lung perfusion model using surgically resected tumorous human lobes.","authors":"Áron Bertram Gellért, Katalin Dezső, Melinda Rezeli, Zsolt Horváth, Sándor Paku, Bence Ferencz, Gyenge Bernát, Kristóf Csende, Hanna Tihanyi, Gábor Tarsoly, Márton Csaba, Sára Lality, Balázs Gieszer, Levente Bogyó, Klára Török, Péter Radeczky, Sára Radványi, Ákos Kocsis, László Agócs, Krisztina Bogos, Lilla Horváth, János Fillinger, Szilvia Török, Anna Sólyom-Tisza, Helga Kiss, András Czirók, Jenő Elek, Ildikó Madurka, Ferenc Rényi-Vámos, Balázs Döme, Zsolt Megyesfalvi, Áron Ghimessy","doi":"10.1186/s12890-026-04512-8","DOIUrl":"10.1186/s12890-026-04512-8","url":null,"abstract":"<p><strong>Background: </strong>Ex vivo lung perfusion (EVLP) is a unique platform for lung assessment and preservation. While EVLP has been extensively investigated in donor lungs, its application to translational research is less well-defined. We aimed to evaluate and characterise the EVLP methodology using resected human cancerous lung.</p><p><strong>Methods: </strong>Between January 2021 and March 2023, 216 patients at our Institute underwent eligibility screening for experimental inclusion. Following pneumonectomy or lobectomy, 10 cases were included. The lung specimens were inflated, flushed with Perfadex^®, and connected to an acellular perfusate circuit primed with Steen^® solution. Physiological parameters were monitored at regular intervals with a blood gas analyser.</p><p><strong>Results: </strong>The median duration of the experiments performed was 159 min, during which the functional parameters remained stable despite the progressive development of oedema. Importantly, elevated lactate levels did not correlate with functional deterioration defined by partial O₂ and CO₂ pressure levels despite a temporal non-significant decline in these parameters. We managed to perfuse pneumonectomy and lobectomy specimens with comparable results regarding the investigated physiological parameters. However, pneumonectomies were associated with shorter median warm ischemic times compared to lobectomies (29.5 min vs. 75 min, respectively).</p><p><strong>Conclusion: </strong>In this study, we have characterised proof-of-concept EVLP in cancerous human lungs regarding physiological parameters. Oedema management and clearly defined endpoints are essential in its translational application. These preliminary observations are intended to guide future investigators for improved protocols and establish standardised criteria for patient selection.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental exposures at home and in the workplace in relation to inhaled corticosteroid medication - the population-based REGAL study.","authors":"Juan Wang, Andreas Palm, Caroline Ahlroth Pind, Mathias Holm, Sven-Erik Dahlén, Lars Modig, Ane Johannessen, Xingwu Zhou, Andrei Malinovschi, Össur Ingi Emilsson","doi":"10.1186/s12890-026-04502-w","DOIUrl":"10.1186/s12890-026-04502-w","url":null,"abstract":"<p><strong>Background: </strong>Diverse environmental exposures - home, occupational, and traffic-related - may impact asthma, but population-based studies on objectively assessed asthma are lacking. We aimed to investigate the impact of these exposures on future inhaled corticosteroid (ICS) use.</p><p><strong>Methods: </strong>Data from two Swedish population-based cohorts (performed in 2008-2010) were linked to the National Prescribed Drug Registry from 2005 to 2018 to form the REGAL study. This analysis included 31,768 participants from Stockholm, Gothenburg, Uppsala, and Umeå. Participants reported asthma diagnosis, asthma-related symptoms, and home and occupational exposures via questionnaires, while ICS prescriptions were retrieved from registry.</p><p><strong>Results: </strong>Among 31,768 participants, 6.9% (n = 2,103) reported asthma medication via questionnaire at baseline, and 5.3% (n = 1,679) initiated ICS therapy during the follow-up period (median follow-up time: 10.7 years). The prevalence of floor dampness, irritating air at home, traffic exposure at home, and occupational exposure to gas, smoke, or dust were 3.8%, 17.9%, 4.0%, and 36.7%, respectively. Floor dampness (odds ratio OR = 1.32, 95%CI 1.06-1.63), irritating air (OR = 2.08, 95%CI 1.85-2.33), traffic exposure at home (OR = 1.48, 95%CI 1.21-1.81), and occupational exposure to gas, smoke, or dust (OR = 1.55, 95%CI 1.39-1.72) were associated with self-reported asthma medication. An increased risk of initiating ICS therapy during the follow-up period was found for floor dampness at home (hazard ratio HR = 1.42, 95%CI 1.14-1.77), irritating air at home (HR = 1.46, 95%CI 1.29-1.65), and previous occupational exposure to gas, smoke, or dust (HR = 1.25, 95%CI 1.12-1.40).</p><p><strong>Conclusions: </strong>Indoor dampness, irritating air at home, and occupational exposure to gas/smoke/dust were associated with self-reported asthma medication at baseline and future initiation of ICS.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13383413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and internal validation of a nomogram to predict pulmonary hypertension in fibrosing interstitial lung diseases.","authors":"David Rodríguez-Plaza, Jesús Ribas, Isabel Alfaya, Sonia López-Monzoni, Guadalupe Bermudo, Vanesa Vicens-Zygmunt, Yolanda Ruiz, Marta Hernández-Argudo, Judith Peñafiel, Belén Del Río, Ángela Díaz, Lara Fuentes, Salud Santos, María Molina-Molina","doi":"10.1186/s12890-026-04495-6","DOIUrl":"10.1186/s12890-026-04495-6","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary hypertension (PH) is a common comorbidity in patients with interstitial lung disease (ILD), with a negative prognostic impact. The main objective of this study was to develop and internally validate a nomogram to predict PH using real-life data from patients with fibrosing ILD.</p><p><strong>Methods: </strong>Retrospective, cross-sectional, single-centre study including adult patients with a diagnosis of fibrosing ILD undergoing right heart catheterization (RHC). Bootstrap was used to select clinical, radiological, and functional predictors of precapillary PH. LASSO, Elastic Net, and CART were also performed to enhance robustness. The final model was presented using a nomogram and PH risk was stratified into three categories according to CART.</p><p><strong>Results: </strong>Ninety patients were included. The most frequent ILD diagnoses were idiopathic pulmonary fibrosis (20%), connective tissue diseases-ILD (18.9%) and combined pulmonary fibrosis and emphysema (17.8%). Echocardiography identified high PH probability in 54.4% of patients. RHC confirmed PH in 64 (71%) patients and ruled out PH in 26 (29%). Pulmonary artery diameter, transfer coefficient of the lung for carbon monoxide (KCO) and six-minute walking test distance (meters) were retained in the final model, with an AUC [95% CI] of 0.857 [0.779-0.935]. PH predicted risk was classified in low- (< 36%), intermediate- (≥ 36-<73%) or high-risk (≥ 73%) categories.</p><p><strong>Conclusion: </strong>A simple model based on three non-invasive objective variables obtained during the routine care of patients with fibrosing ILD showed good internal discrimination in our derivation cohort. Following external validation, the proposed nomogram could support PH-ILD suspicion and optimize echocardiography and RHC referrals.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring differences in alveolar microbiome between pulmonary tuberculosis patients with different treatment outcomes: a metagenomic study from China.","authors":"Qiu Chao-Chao, Lin Zhi-Ruo, Lin Xiao-Qing, Mei Yan-Hong, Zhou Yue-Ying, Pan Ning, Shi Ji-Chan, Jiang Xian-Gao","doi":"10.1186/s12890-026-04500-y","DOIUrl":"10.1186/s12890-026-04500-y","url":null,"abstract":"<p><p>This study aimed to investigate differences in the composition and functional characteristics of alveolar microbiota in patients with pulmonary tuberculosis (PTB) exhibiting differential therapeutic responses. Thirty-two patients with drug-sensitive PTB who had completed standard anti-tuberculosis therapy were enrolled and classified into good-response (n = 16) and poor-response (n = 16) groups. Bronchoalveolar lavage fluid (BALF) samples were collected and analysed using metagenomic sequencing to characterize microbial community and functional pathways. No significant differences were observed in α-diversity between the two groups; however, β-diversity analysis demonstrated moderate but significant in microbial community structure (ANOSIM, R = 0.381, P < 0.001). The good efficacy group was characterized by enrichment of Prevotella, Staphylococcus, and oral commensal bacteria including Fusobacterium and Rothia, together with significantly increased pathways related to peptidoglycan biosynthesis, glutathione metabolism, energy production, and DNA repair. In contrast, the poor efficacy group was characterised by enrichment of Microbacterium and activation of functional pathways associated with biofilm formation. These findings suggest that both the taxonomic composition and functional activity of the pulmonary microbiome are closely associated with anti-tuberculosis treatment outcomes.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and risk factors for mortality among hospitalized patients with pulmonary tuberculosis in Shizuoka Prefecture in 2009-2020.","authors":"Kei Kanata, Toshihiro Shirai, Yutaro Kishimoto, Taisuke Akamatsu, Yutaro Ito, Koshiro Ichijo, Masahiro Uehara","doi":"10.1186/s12890-026-04521-7","DOIUrl":"10.1186/s12890-026-04521-7","url":null,"abstract":"<p><strong>Background: </strong>Japan had long been a medium-burden country for tuberculosis (TB) but became a low-burden country in 2021. Shizuoka Prefecture is geographically located in Central Japan, and the incidence rate of TB is also at the average level in Japan. This study aimed to understand TB patients' characteristics and risk factors by analyzing the data from 2009 to 2020 in Shizuoka Prefecture, a representative sample for Japan.</p><p><strong>Methods: </strong>We retrospectively collected 1,132 patients with smear-positive pulmonary TB who were admitted to Shimada General Medical Center or Shizuoka General Hospital in the central area of Shizuoka Prefecture from 2009 to 2020. Patients were divided into alive and dead (i.e., all-cause in-hospital death during anti-tuberculosis treatment) groups, and clinical parameters were compared between the two groups.</p><p><strong>Results: </strong>The median age of all patients was 80. The number of patients decreased from 2009 to 2020. Moreover, the number of patients over 70 gradually reduced, which was similar for all patients. Immigrant TB patients were 5% of all patients, which was very small compared to the total number of patients. Almost all were from Southeast Asian countries. In multivariate analysis, older age, low body mass index, respiratory failure, low serum albumin, lymphocyte, high serum creatinine levels, and neutrophil were independent prognostic factors.</p><p><strong>Conclusions: </strong>The decline in TB among elderly patients, who comprise most of the population, might be one reason why Japan has become a low-burden country. Although the rate of immigrants is minimal, caution is needed about the increase, especially from Southeast Asian countries. There is a need for a TB medical system that can deal with complications and malnutrition, which are risk factors for death.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of the pulmonary rehabilitation Kinesiophobia scale for patients with chronic obstructive pulmonary disease.","authors":"Di Yang, Lu Wang, Guixing Liang, Pin Liu, Meizhu Ding","doi":"10.1186/s12890-026-04522-6","DOIUrl":"10.1186/s12890-026-04522-6","url":null,"abstract":"<p><strong>Background: </strong>Kinesiophobia is a significant barrier to pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). However, there is currently a lack of a specific assessment tool for kinesiophobia in Chinese COPD patients. This study aims to develop the Pulmonary Rehabilitation Kinesiophobia Scale for Patients with COPD and to evaluate its psychometric properties.</p><p><strong>Methods: </strong>This study was conducted in two stages. Stage I (instrument development): Based on literature review, qualitative interviews, and expert consultation, a preliminary version of the scale was developed. Stage II (item evaluation and psychometric testing): From April to September 2024, A total of 323 COPD patients from a tertiary hospital in Guangzhou completed the scale survey via convenience sampling. Data were analyzed for item selection, as well as reliability and validity testing. Reliability was assessed using internal consistency, test-retest reliability, and split-half reliability. Validity was evaluated through content validity, construct validity, and criterion-related validity. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to assess the scale's structure. For criterion-related validity, the correlation was analyzed between scale scores and the Modified Medical Research Council Dyspnea Scale (mMRC), the COPD Assessment Test (CAT), and the 6-minute walk distance (6-MWD).</p><p><strong>Results: </strong>The scale comprises 17 items. EFA revealed a reasonable distribution of factor loadings across five factors, with a cumulative variance explained of 70.7%. This factor structure was further supported by CFA, and the model fit indicators were: χ²/df = 1.555, RMSEA = 0.053, GFI = 0.906, IFI = 0.958, TLI = 0.946, and CFI = 0.957. Reliability analysis showed a Cronbach's α of 0.910, test-retest reliability of 0.844, and split-half reliability of 0.930. The content validity index I-CVI was 0.83-1.00, the S-CVI/UA was 0.824, and the S-CVI/Ave was 0.971. The correlation coefficients between the scale scores and mMRC, CAT, and 6MWD were 0.753, 0.731, and - 0.538, respectively.</p><p><strong>Conclusions: </strong>The Pulmonary Rehabilitation Kinesiophobia Scale for Patients with COPD demonstrates good reliability and validity, which can be used to assess kinesiophobia in this population.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COPD is associated with poorer survival in patients with advanced non-small cell lung cancer treated with first-line ICI plus chemotherapy.","authors":"Akihisa Takano, Daisuke Shibahara, Hiroaki Ogata, Sai Yasukochi, Ryosuke Matsukane, Toshifumi Ninomiya, Takahiro Utsumi, Yuki Ikematsu, Kohei Otsubo, Yoshimasa Shiraishi, Eiji Iwama, Mayako Uchida, Isamu Okamoto","doi":"10.1186/s12890-026-04509-3","DOIUrl":"10.1186/s12890-026-04509-3","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) frequently coexists with non-small cell lung cancer (NSCLC). Previous studies suggest that COPD may be associated with improved outcomes in patients receiving immune checkpoint inhibitor (ICI) monotherapy, but its impact in patients treated with ICI plus chemotherapy remains unclear.</p><p><strong>Methods: </strong>In this retrospective single-institution study, we evaluated 55 ever-smokers with stage IV NSCLC treated with first-line ICI plus chemotherapy who underwent pulmonary function testing. COPD was defined as a post-bronchodilator FEV₁/FVC ratio < 0.70, and patients were classified into COPD (n = 33) and non-COPD (n = 22) groups. Progression-free survival (PFS) and overall survival (OS) were analyzed using Kaplan-Meier methods and Cox proportional hazards models. To reduce baseline confounding, inverse probability of treatment weighting (IPTW) based on propensity scores was applied.</p><p><strong>Results: </strong>In unadjusted analyses, median PFS was 5.3 months in the COPD group and 11.1 months in the non-COPD group (hazard ratio [HR] 1.79, 95% confidence interval [CI] 0.95-3.37; p = 0.071). After IPTW adjustment, PFS was significantly shorter in the COPD group (median 4.6 months vs 13.7 months; HR 2.54, 95% CI 1.29-5.00; p = 0.007). In unadjusted analyses, median OS was 12.7 months in the COPD group and not reached in the non-COPD group (HR 1.56, 95% CI 0.73-3.33; p = 0.247). After IPTW adjustment, OS was significantly shorter in the COPD group (median 11.8 months vs not reached; HR 3.00, 95% CI 1.16-7.73; p = 0.023).</p><p><strong>Conclusions: </strong>COPD may be associated with poorer survival among ever-smokers with advanced NSCLC receiving first-line ICI plus chemotherapy, although further validation in larger cohorts is warranted.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between plasma transfusion and in-hospital mortality in severe pneumonia: a propensity score-matched retrospective cohort study.","authors":"Linyan Wu, Zekui Fang, Xiping Wu, Kunzuo Yu, Ning Jiang, Minhong Su","doi":"10.1186/s12890-026-04497-4","DOIUrl":"10.1186/s12890-026-04497-4","url":null,"abstract":"<p><strong>Background: </strong>Plasma transfusion is used in patients with severe pneumonia who develop coagulopathy or bleeding, but recipients are often sicker than non-recipients. We evaluated the association between plasma transfusion and in-hospital mortality after adjustment for available measured confounders, while recognizing that unmeasured confounding from transfusion indications and illness severity may persist.</p><p><strong>Methods: </strong>This single-center retrospective cohort included 156 adults with severe pneumonia admitted between January 2021 and May 2024; 62 received plasma and 94 did not. The matched mortality comparison using propensity score matching (PSM) and McNemar analysis was prespecified as the primary analysis. Supportive and exploratory analyses included Cox regression, Kaplan-Meier analysis, IPTW, overlap weighting, Fine-Gray modeling, E-value analysis, and exploratory coagulation-enhanced, logistic, microbiological/coagulation, and time-dependent exposure sensitivity analyses.</p><p><strong>Results: </strong>Before matching, mortality was higher among plasma recipients than controls (64.5% vs. 28.0%; crude odds ratio [OR] 4.69, 95% confidence interval [CI] 2.35-9.34; p < 0.001), with substantial baseline imbalance. After matching, mortality remained numerically higher in the plasma group (50.0% vs. 36.1%) but was not statistically significant (matched OR 1.62, 95% CI 0.67-3.92; McNemar p = 0.383). Cox models yielded attenuated HRs after adjustment, but the fully adjusted model violated the global proportional hazards assumption; therefore, Cox estimates were interpreted as time-weighted associations over follow-up rather than constant effects. Exploratory sensitivity estimates varied in direction across estimands: coagulation-enhanced matching yielded OR 1.50 (95% CI 0.53-4.21), full-cohort logistic regression yielded adjusted OR 3.19 (95% CI 1.12-9.11), approximate adjusted time-dependent Cox analysis yielded HR 1.73 (95% CI 0.85-3.51), and strict verified-date adjusted time-dependent Cox analysis yielded HR 2.67 (95% CI 1.38-5.16).</p><p><strong>Conclusions: </strong>The attenuation of the crude mortality difference after propensity score matching is consistent with baseline severity and confounding by indication accounting for a substantial component of the unadjusted association; however, residual confounding cannot be excluded. Because residual confounding, immortal-time bias, related time-dependent exposure bias, and proportional-hazards violations remain important limitations, these data do not establish a definitive beneficial or harmful effect of plasma transfusion. The non-significant matched result reflects limited statistical power (approximately 25% for a paired OR of 2.0) and should not be interpreted as evidence of no effect.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}