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Original research
Survival of patients with asbestosis can be assessed by risk-predicting models
  1. Eerika Keskitalo1,2,
  2. Johanna Salonen1,2,
  3. Hannu Vähänikkilä3,
  4. Riitta Kaarteenaho1,2
  1. 1Research Unit of Internal Medicine, University of Oulu, Oulu, Finland
  2. 2Medical Research Center (MRC) Oulu, Oulu University Hospital, Oulu, Finland
  3. 3Infrastructure for Population Studies, University of Oulu, Oulu, Finland
  1. Correspondence to Eerika Keskitalo, Research Unit of Internal Medicine, University of Oulu, Oulu, Finland; Eerika.Keskitalo{at}


Objectives Our aim was to investigate the pulmonary function test (PFT) results of patients with asbestosis and determine whether baseline PFTs and the risk-predicting models such as gender, age and physiologic (GAP) variables model and composite physiologic index (CPI) would be useful in predicting survival in these patients.

Methods Demographics and PFTs of 100 patients with asbestosis were evaluated. The survival difference between the GAP stages was determined with Kaplan-Meier survival curves with statistical significance analysed with log-rank test. The suitability of the risk-predicting models and baseline PFTs to predict the survival of patients was analysed with Cox regression.

Results At baseline, the mean value of diffusion capacity for carbon monoxide (DLCO) was 65%; for forced vital capacity it was 81%, with restrictive lung function being the most common impairment. The median estimated survival of the patients was 124 months, that is, 171 months in GAP stage I, 50 months in stage II and 21 months in stage III (p<0.001). CPI, DLCO% predicted, age at baseline and GAP stage were significant predictors of mortality (all p values under 0.001).

Conclusions GAP and CPI as well as baseline DLCO% predicted were significant parameters in the evaluation of the prognosis of the patients with asbestosis; they may be useful in clinical practice when considering treatment strategies of individual patients.

  • asbestos
  • pneumoconioses
  • lung function
  • respiratory

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  • Contributors EK collected the study material, analysed and interpreted the data and prepared the draft of the manuscript. JS participated in the interpretation of data. HV participated in the statistical data analyses. RK managed and designed the study, planned the data collection form and interpreted the data. All authors have read and approved the final manuscript.

  • Funding EK has received grants for scientific work from the Research Foundation of the Pulmonary Diseases and the Foundation of the Finnish Anti-Tuberculosis Association. JS has received grants for scientific work from the Foundation of the Finnish Anti-Tuberculosis Association and the Research Foundation of the Pulmonary Diseases. RK has received grants for the study group from the Foundation of the Finnish Anti-Tuberculosis Association, the Research Foundation of the Pulmonary Diseases, the Research Foundation of North Finland, the Jalmari and Rauha Ahokas Foundation and a state subsidy of the Oulu University Hospital. Funding bodies have not affected the contents of this study.

  • Competing interests The authors have the following competing interests that have not affected the contents of this study. EK reports congress fees and travel costs from Orion Pharma. JS reports congress fees and travel costs from Boehringer-Ingelheim, Novartis, Orion Pharma, Ratiopharm and Roche, and lecture fees from Boehringer-Ingelheim, Chiesi, GlaxoSmithKline, Mundipharma, Orion Pharma and Roche. RK has received a congress travel cost from Orion Pharma; consulting fees from Boehringer-Ingelheim and lecture fees from Roche, Boehringer-Ingelheim and Ratiopharm. HV declare no competing interests.

  • Patient consent for publication Not required.

  • Ethics approval The study protocol was approved by the Research Ethics Committee of the Northern Ostrobothnia Hospital District. The permission to use data from death certificates was given by Statistics Finland. This study was conducted in compliance with the Declaration of Helsinki. No consents for the inclusion into this study were collected because of its retrospective design and due to the fact that most of the patients were already deceased. In addition, in accordance with Finnish legislation, consent would not be required because of the register-based nature of the project.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.