BACKGROUND & AIMS: BACKGROUND:Hospitalized COVID-19 patients tend to be older and frequently have hypertension, diabetes, or coronary heart disease, but whether these comorbidities are true risk factors (ie, more common than in the general older population) is unclear. We estimated associations between preexisting diagnoses and hospitalized COVID-19 alone or with mortality, in a large community cohort. METHODS:UK Biobank (England) participants with baseline assessment 2006-2010, followed in hospital discharge records to 2017 and death records to 2020. Demographic and preexisting common diagnoses association tested with hospitalized laboratory-confirmed COVID-19 (March 16 to April 26, 2020), alone or with mortality, in logistic models. RESULTS:Of 269 070 participants aged older than 65, 507 (0.2%) became COVID-19 hospital inpatients, of which 141 (27.8%) died. Common comorbidities in hospitalized inpatients were hypertension (59.6%), history of fall or fragility fractures (29.4%), coronary heart disease (21.5%), type 2 diabetes (type 2, 19. 9%), and asthma (17.6%). However, in models adjusted for comorbidities, age group, sex, ethnicity, and education, preexisting diagnoses of dementia, type 2 diabetes, chronic obstructive pulmonary disease, pneumonia, depression, atrial fibrillation, and hypertension emerged as independent risk factors for COVID-19 hospitalization, the first 5 remaining statistically significant for related mortality. Chronic kidney disease and asthma were risk factors for COVID-19 hospitalization in women but not men. CONCLUSIONS:There are specific high-risk preexisting comorbidities for COVID-19 hospitalization and related deaths in community-based older men and women. These results do not support simple age-based targeting of the older population to prevent severe COVID-19 infections.

背景与目标：

BACKGROUND & AIMS: INTRODUCTION:Conventionally, little attention has been given to the association of risk factors and medical comorbidities with male sexual dysfunctions. Although that association has been recently shown in many studies, it is not yet well investigated in the Saudi community. AIM:To investigate the association of risk factors and medical comorbidities with male sexual dysfunctions in the Saudi community. METHODS:A total of 1,464 male patients with a clinical diagnosis of sexual dysfunctions were enrolled in this study. All patients were assessed for sexual functions using different domains of the International Index for Erectile Function. Patients were also interviewed for sociodemographic data, medical history, and risk factors for erectile dysfunction (ED). Routine laboratory investigations, plus total testosterone and prolactin assessments, were offered to all patients. Assessments of penile vasculature using Doppler ultrasonography and rigidometer were performed. RESULTS:A total of 92.6% of the patients had ED, 50.8% had premature ejaculation (PE), and 7.6% had low sexual desire. There was a significant association between increased age and increased severity of ED. In total, 20% had psychogenic cause, whereas 80% had organic cause of ED. Of the patients, 10.2% had mild, 41% had moderate, and 48.8% had severe ED. There were significant associations between endocrinopathy and both low sexual desire and PE (P < 0.05). There were significant associations between increased severity of ED and presence of diabetes, hypertension, dyslipidemia, ischemic heart disease, myocardial infarction, and psychological disorders. There were significant associations between increased severity of ED and increased values of end diastolic velocity, decreased values of peak systolic velocity, resistive index, rigidometer, and decreased response to intracavernosal injection (P < 0.001). CONCLUSION:This study provides an assessment of the association of risk factors and medical comorbidities with male sexual dysfunctions in ambulatory service in this community.

背景与目标：

BACKGROUND & AIMS: :Identification of individuals at risk of developing disease comorbidities represents an important task in tackling the growing personal and societal burdens associated with chronic diseases. We employed machine learning techniques to investigate to what extent data from longitudinal, nationwide Danish health registers can be used to predict individuals at high risk of developing type 2 diabetes (T2D) comorbidities. Leveraging logistic regression-, random forest- and gradient boosting models and register data spanning hospitalizations, drug prescriptions and contacts with primary care contractors from >200,000 individuals newly diagnosed with T2D, we predicted five-year risk of heart failure (HF), myocardial infarction (MI), stroke (ST), cardiovascular disease (CVD) and chronic kidney disease (CKD). For HF, MI, CVD, and CKD, register-based models outperformed a reference model leveraging canonical individual characteristics by achieving area under the receiver operating characteristic curve improvements of 0.06, 0.03, 0.04, and 0.07, respectively. The top 1,000 patients predicted to be at highest risk exhibited observed incidence ratios exceeding 4.99, 3.52, 1.97 and 4.71 respectively. In summary, prediction of T2D comorbidities utilizing Danish registers led to consistent albeit modest performance improvements over reference models, suggesting that register data could be leveraged to systematically identify individuals at risk of developing disease comorbidities.

背景与目标： : 识别有患疾病合并症风险的个体是应对与慢性疾病相关的日益增长的个人和社会负担的一项重要任务。我们采用机器学习技术来调查来自丹麦全国范围内的纵向健康登记册的数据在多大程度上可以用于预测罹患2型糖尿病 (T2D) 合并症的高风险个体。利用逻辑回归、随机森林和梯度提升模型，并登记来自> 200,000名新诊断为T2D的个体的住院、药物处方和初级保健承包商接触的数据，我们预测了心力衰竭 (HF) 、心肌梗死 (MI) 、中风 (ST) 的五年风险，心血管疾病 (CVD) 和慢性肾脏疾病 (CKD)。对于HF、MI、CVD和CKD，基于寄存器的模型通过分别实现0.06、0.03、0.04和0.07的接收器工作特性曲线下的面积改进而优于利用规范个体特性的参考模型。预计风险最高的前1,000名患者的发生率分别超过4.99、3.52、1.97和4.71。总之，利用丹麦寄存器对T2D合并症的预测导致了与参考模型相比持续的尽管适度的性能改善，这表明可以利用寄存器数据来系统地识别有发生疾病合并症风险的个体。

BACKGROUND & AIMS: :Although somatic complains are the predominant reasons for seeking general medical care, there has been limited research on the clinical presentation of somatic symptoms in primary care settings in developing countries. The frequency of somatic symptoms in primary care in Qatar and its relationship to comorbidities of mental disorders is presented here. A total of 2,320 Arab patients were approached, of whom 76% agreed to participate for the survey conducted among primary healthcare (PHC) centre patients. The study was conducted with the help of general practitioners (GPs), using the General Health Questionnaire (GHQ-12), Patient Health Questionnaire (PHQ)-8 for depression, the Generalized Anxiety Disorder Scale (GAD)-7 for anxiety, PHQ-15 for somatic symptoms and the Psychological Stress Measure (PSM)-9 for stress. Of the subjects with somatic symptoms (229 cases), most were Qataris (57.2%). Poor hearing (52.1%), palpitation (47.1%) and stomach pain (43.8%) were the most common in men, whereas constipation (54.6%), feeling depressed (50.9%), and poor hearing (50.6%) were the most common in women; 48.5% had more than four somatic symptoms. Somatic symptoms were severe in 31.9%. Somatic symptoms were associated with depression (15.3%), anxiety (8.7%) and stress disorders (19.2%). The study findings revealed that somatic symptoms were significantly associated with socio-economic status. Somatic symptoms were significantly associated with depression, anxiety and stress disorders.

背景与目标： : 尽管躯体疾病是寻求一般医疗保健的主要原因，但在发展中国家的初级保健机构中，关于躯体症状的临床表现的研究有限。本文介绍了卡塔尔初级保健中躯体症状的发生频率及其与精神障碍合并症的关系。共接触了2,320名阿拉伯患者，其中76% 名同意参加在初级保健 (PHC) 中心患者中进行的调查。该研究是在全科医生 (GPs) 的帮助下进行的，使用一般健康问卷 (GHQ-12)，患者健康问卷 (PHQ)-8用于抑郁症，广泛焦虑症量表 (GAD)-7用于焦虑，躯体症状的PHQ-15和压力的心理压力测量 (PSM)-9。在具有躯体症状的受试者中 (229例)，大多数是卡塔尔人 (57.2% 例)。男性最常见的是听力差 (52.1%)，心悸 (47.1%) 和胃痛 (43.8%)，而女性最常见的是便秘 (54.6%)，情绪低落 (50.9%) 和听力差 (50.6%); 48.5% 有四种以上的躯体症状。31.9% 的躯体症状严重。躯体症状与抑郁 (15.3%) 、焦虑 (8.7%) 和应激障碍 (19.2%) 相关。研究结果表明，躯体症状与社会经济地位显着相关。躯体症状与抑郁，焦虑和压力障碍显着相关。

BACKGROUND & AIMS: :HIV infection and antiretroviral therapies have detrimental effects on bone metabolism, but data on their impact on fracture risk are controversial. We conducted a population-based cohort study to explore the association between clinical diagnosis of HIV infection and hip and major osteoporotic fracture risk. Data were obtained from the SIDIAP(Q) database, which contains clinical information for >2 million patients in Catalonia, Spain (30% of the population). We screened the database to identify participants with a clinical diagnosis of HIV infection, and ascertained incident hip and osteoporotic major fractures in the population aged 40 years or older in 2007 to 2009. In addition, data on incident fractures involving hospital admission were obtained from the Hospital Admissions database. Cox regression models were used to estimate hazard ratios (HRs) for the HIV-infected versus uninfected participants. Models were adjusted for age, sex, body mass index, smoking status, alcohol drinking, oral glucocorticoid use, and comorbid conditions (Charlson index). Among 1,118,156 eligible participants, we identified 2489 (0.22%) subjects with a diagnosis of HIV/AIDS. Age- and sex-adjusted HR for HIV/AIDS were 6.2 (95% confidence interval [CI] 3.5-10.9; p < 0.001) and 2.7 (2.01-3.5; p < 0.001) for hip and major fractures, respectively; this remained significant after adjustment for all mentioned potential confounders: HR 4.7 (2.4-9.5; p < 0.001) and 1.8 (1.2-2.5; p = 0.002). After stratifying by age, the association between HIV infection and major fractures was attenuated for those aged <59 years (adjusted HR 1.35 [0.88-2.07], p = 0.17) but appeared stronger in older patients (adjusted HR 2.11 [1.05-4.22], p = 0.035). We report a strong association between HIV infection and hip fracture incidence, with an almost fivefold increased risk in the HIV infected, independent of sex, age, smoking, alcohol drinking, and comorbidities. Similarly, we demonstrate a 75% higher risk of all clinical fractures and a 60% increase in risk of non-hip clinical fractures among patients with a diagnosis of HIV infection.

背景与目标： : HIV感染和抗逆转录病毒疗法对骨代谢有不利影响，但有关其对骨折风险影响的数据仍存在争议。我们进行了一项基于人群的队列研究，以探讨HIV感染的临床诊断与髋部和主要骨质疏松性骨折风险之间的关系。数据是从SIDIAP(Q) 数据库获得的，该数据库包含西班牙加泰罗尼亚> 200万名患者的临床信息 (占人口的30%)。我们对数据库进行了筛选，以识别临床诊断为HIV感染的参与者，并确定了40岁以上人群中发生的髋关节和骨质疏松性主要骨折2007年2009年。此外，从医院入院数据库中获得了涉及入院的突发骨折的数据。Cox回归模型用于估计HIV感染与未感染参与者的风险比 (HRs)。对模型进行了年龄，性别，体重指数，吸烟状况，饮酒，口服糖皮质激素使用和合并症的校正 (Charlson指数)。在1,118,156名符合条件的参与者中，我们确定了2489 (0.22%) 诊断为HIV/AIDS的受试者。对于髋部和主要骨折，年龄和性别校正的HR分别6.2 (95% 置信区间 [CI] 3.5-10.9; P  <  0.001) 和2.7 (2.01-3.5; P  <  0.001); 在对所有提到的潜在混杂因素进行校正后，这仍然很重要: HR 4.7 (2.4-9.5; P  <  0.001) 和1.8 (1.2-2.5; P   =   0.002)。按年龄分层后，年龄 <59岁 (调整后的HR 1.35 [0.88-2.07]，p   =   0.17) 的患者HIV感染与主要骨折之间的关联减弱，但在老年患者中表现更强 (调整后的HR 2.11 [1.05-4.22]，p   =   0.035)。我们报告了HIV感染与髋部骨折发生率之间的密切关联，HIV感染的风险几乎增加了五倍，而与性别，年龄，吸烟，饮酒和合并症无关。同样，我们证明在诊断为HIV感染的患者中，所有临床骨折的风险75% 高，非髋部临床骨折的风险60% 增加。

BACKGROUND & AIMS: OBJECTIVE:Investigate the prevalence, comorbidities, and correlates of challenging behaviors among clients of the New South Wales Brain Injury Rehabilitation Program. SETTING:All community-based rehabilitation services of the statewide program. PARTICIPANTS:Five hundred seven active clients with severe traumatic brain injury. DESIGN:Prospective multicenter study. MAIN MEASURES:Eighty-eight clinicians from the 11 services rated clients on the Overt Behaviour Scale, Disability Rating Scale, Sydney Psychosocial Reintegration Scale-2, Care and Needs Scale, and Health of the Nation Outcome Scale-Acquired Brain Injury. RESULTS:Overall prevalence rate of challenging behaviors was 54%. Inappropriate social behavior (33.3%), aggression (31.9%), and adynamia (23.1%) were the 3 most common individual behaviors, with 35.5% of the sample displaying more than 1 challenging behavior. Significant associations were found between increasing levels of challenging behavior and longer duration of posttraumatic amnesia, increasing functional disability, greater restrictions in participation, increased support needs, and greater degrees of psychiatric disturbance, respectively (P < 0.004). Multivariate binomial logistic regression found that premorbid alcohol abuse, postinjury restrictions in participation, and higher levels of postinjury psychiatric disturbance were independent predictors of challenging behavior. CONCLUSIONS:Challenging behaviors are widespread among community-dwelling adults with severe traumatic brain injury. Services need to deliver integrated anger management, social skills, and motivational treatments.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Major increases in the survival of people with Down syndrome during the last two generations have resulted in extended periods of adulthood requiring specialist care, which in turn necessitates greater understanding of the nature, timing and impact of comorbidities associated with the disorder. METHOD:The prevalence of five comorbidities reported as common in adults with Down syndrome, visual impairment, hearing impairment, epilepsy, thyroid disorders and dementia was assessed by decade of life. RESULTS:From early adulthood, people with Down syndrome are at enhanced risk of developing new comorbidities and they may present with multiple conditions. Three specific challenges are identified and discussed: are comorbidities detected in a timely manner, is the clinical progress of the disorder adequately understood, and who is responsible for the provision of care? CONCLUSIONS:Further detailed investigations into the development and treatment of comorbidities across the lifespan are needed for a successful longitudinal approach to healthcare in people with Down syndrome. Implementation of this approach will better inform healthcare providers to ensure continuity of care with advancing age.

背景与目标：

BACKGROUND & AIMS: :There is an unmet need to improve therapy for neuropsychiatric comorbidities that are highly prevalent in persons with epilepsy (PWE). However, diagnosing and monitoring the neurobehavioral symptoms is challenging as their presentation can overlap with seizures. In this retrospective study, we report the advantage of chronic ambulatory electrocorticography (ECoG) from implanted Responsive Neurostimulator System (RNS®) in characterizing these psychosomatic paroxysms as a possible ictal, postictal, or interictal phenomenon and how the diagnosis guided the therapy choices. Five out of 21 patients with RNS had neuropsychiatric symptoms (panic attack, psychosis, conversion, and somatization disorders) that overlapped with their seizure semiology and were found to benefit from the use of RNS ECoG data by timely diagnosing and titrating targeted therapies. The cases illustrate the use of RNS ECoG data in diagnosing and improving the management of comorbidities in PWE. The ability to access RNS ECoG data and correlate it with patient symptoms is unique among available therapeutic options for PWE.

背景与目标： : 对于癫痫患者 (pwwe) 中非常普遍的神经精神合并症，改善治疗的需求尚未得到满足。然而，诊断和监测神经行为症状具有挑战性，因为它们的表现可能与癫痫发作重叠。在这项回顾性研究中，我们报告了植入的反应性神经刺激器系统 (RNS) 的慢性动态皮层脑电图 (ECoG) 的优势®) 将这些心身发作表征为可能的发作期，发作期或发作期现象，以及诊断如何指导治疗选择。在21例RNS患者中，有5例具有与癫痫发作符号学重叠的神经精神症状 (惊恐发作，精神病，转换和躯体化障碍)，并通过及时诊断和滴定靶向治疗而受益于RNS ECoG数据的使用。这些案例说明了RNS ECoG数据在诊断和改善pw我们合并症中的管理中的应用。访问RNS ECoG数据并将其与患者症状相关联的能力在pwwe的可用治疗选择中是独一无二的。

BACKGROUND & AIMS: :Evidence continues to accumulate on the rising burden of diabetes mellitus at a higher pace in Africa. In a series of two papers, we sought to summarise recent evidence on diabetes and obesity in Africa based on a systematic review of studies published between January 2002 and October 2012. This first paper on the prevalence, pathogenesis and comorbidities shows that the increase in diabetes prevalence has paralleled that of obesity in Africa. Recent surveys on diabetes and obesity have been largely suboptimal. Hence, the need for more representative and robust continent-wide prevalence figures, which may be somehow achieved through pooling of existing data. Prospective studies linking environmental risk factors to disease occurrence and outcomes remain scarce, and genetic factors for diabetes or obesity have not been extensively assessed. The health consequences of diabetes are manifold, and include a complex interaction with other conditions like HIV infection and sickle cell disease/trait.

背景与目标： : 非洲糖尿病负担日益增加的证据继续积累。在两篇论文中，我们试图根据对2002年1月和2012年10月之间发表的研究的系统回顾，总结非洲糖尿病和肥胖的最新证据。关于患病率，发病机制和合并症的第一篇论文表明，糖尿病患病率的增加与非洲肥胖的增加平行。最近关于糖尿病和肥胖的调查基本上是次优的。因此，需要更具代表性和强大的全大陆流行率数字，这可以通过汇集现有数据以某种方式实现。将环境危险因素与疾病发生和结局联系起来的前瞻性研究仍然很少，并且尚未广泛评估糖尿病或肥胖的遗传因素。糖尿病对健康的影响是多方面的，包括与其他疾病 (如HIV感染和镰状细胞疾病/特征) 的复杂相互作用。

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BACKGROUND & AIMS: OBJECTIVE:To identify, for patients in states of seriously impaired consciousness, comorbid conditions present during inpatient rehabilitation and their association with function at 1 year. DESIGN:Abstracted data from a prospective cross-sectional observational study with data collection occurring January 1996 through December 2007. SETTING:Four inpatient rehabilitation facilities in metropolitan areas. PARTICIPANTS:The study sample of 68 participants is abstracted from a database of 157 patients remaining in states of seriously impaired consciousness for at least 28 days. INTERVENTIONS:Not applicable. MAIN OUTCOME MEASURE:One-year cognitive, motor, and total FIM score. RESULTS:The most common medical complications during inpatient rehabilitation for the study sample are active seizures (46%), spasticity (57%), urinary tract infections (47%), and hydrocephalus with and without shunt (38%). Presence of ≥3 medical complications during inpatient rehabilitation, controlling for injury severity, is significantly (P<.05) associated with poorer total FIM and FIM motor scores 1 year after injury. The presence of hydrocephalus with and without shunt (r=-.20, -.21, -.18; P ≤.15), active seizures (r=-.31, -.22, -.42), spasticity (r=-.38, -.28, -.40), and urinary tract infections (r=-.25, -.24, -.26) were significantly (P<.10) associated with total FIM, FIM cognitive, and FIM motor scores, respectively. CONCLUSIONS:Reported findings indicate that persons in states of seriously impaired consciousness with higher numbers of medical complications during inpatient rehabilitation are more likely to have lower functional levels 1-year postinjury. The findings indicate that persons with ≥3 medical complications during inpatient rehabilitation are at a higher risk for poorer functional outcomes at 1 year. It is, therefore, prudent to evaluate these patients for indications of these complications during inpatient rehabilitation.

背景与目标：

BACKGROUND & AIMS: :Hidradenitis suppurativa (HS) is a chronic inflammatory disease characterized by painful recurrent inflammatory nodules, leading to the formation of abscesses and scarring. In this article, we aim to review the psychiatric comorbidities in HS patients. It is estimated that one in four adults with HS suffers from depression and one out of five patients HS patients has anxiety. Bipolar disorders, psychoses, schizophrenia, and suicide are more common in HS patients than healthy individuals. Given the high rates of psychiatric comorbidities in HS patients, a psychosocial evaluation at an early visit could be a great tool for monitoring patients experiencing emotional burden. Referrals to psychiatric specialists, psychologists, and behavioral counselors are a part of a multidisciplinary approach recommended for the management of HS.

背景与目标： 化脓性汗腺炎 (HS) 是一种慢性炎症性疾病，其特征是疼痛性复发性炎性结节，导致脓肿和瘢痕形成。在本文中，我们旨在回顾HS患者的精神病合并症。据估计，四分之一的HS成年人患有抑郁症，五分之一的HS患者焦虑。双相情感障碍，精神病，精神分裂症和自杀在HS患者中比健康个体更常见。鉴于HS患者的精神病合并症发生率很高，因此在早期就诊时进行心理社会评估可能是监测患有情绪负担的患者的绝佳工具。推荐给精神病学专家，心理学家和行为咨询师是推荐用于HS管理的多学科方法的一部分。

BACKGROUND & AIMS: Background:Fast progression of the transaortic mean gradient (Pmean) is relevant for clinical decision making of valve replacement in patients with moderate and severe aortic stenosis (AS) patients. However, there is currently little knowledge regarding the determinants affecting progression of transvalvular gradient in AS patients. Methods:This monocentric retrospective study included consecutive patients presenting with at least two transthoracic echocardiography examinations covering a time interval of one year or more between April 2006 and February 2016 and diagnosed as moderate or severe aortic stenosis at the final echocardiographic examination. Laboratory parameters, medication, and prevalence of eight known cardiac comorbidities and risk factors (hypertension, diabetes, coronary heart disease, peripheral artery occlusive disease, cerebrovascular disease, renal dysfunction, body mass index ≥30 Kg/m2, and history of smoking) were analyzed. Patients were divided into slow (Pmean < 5 mmHg/year) or fast (Pmean ≥ 5 mmHg/year) progression groups. Results:A total of 402 patients (mean age 78 ± 9.4 years, 58% males) were included in the study. Mean follow-up duration was 3.4 ± 1.9 years. The average number of cardiac comorbidities and risk factors was 3.1 ± 1.6. Average number of cardiac comorbidities and risk factors was higher in patients in slow progression group than in fast progression group (3.3 ± 1.5 vs 2.9 ± 1.7; P=0.036). Patients in slow progression group had more often coronary heart disease (49.2% vs 33.6%; P=0.003) compared to patients in fast progression group. LDL-cholesterol values were lower in the slow progression group (100 ± 32.6 mg/dl vs 110.8 ± 36.6 mg/dl; P=0.005). Conclusion:These findings suggest that disease progression of aortic valve stenosis is faster in patients with fewer cardiac comorbidities and risk factors, especially if they do not have coronary heart disease. Further prospective studies are warranted to investigate the outcome of patients with slow versus fast progression of transvalvular gradient with regards to comorbidities and risk factors.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:The objectives of this community-based study were to examine the overall and changing (1990-2007) frequency and impact on 30-day and 1-year death rates from multiple cardiovascular comorbidities in adults from a large central New England metropolitan area hospitalized with acute myocardial infarction (AMI). METHODS:The study population consisted of 9581 patients hospitalized with AMI at all 11 medical centers in the metropolitan area of Worcester, MA, during 10 annual periods between 1990 and 2007. The comorbidities examined included atrial fibrillation, diabetes, heart failure, hypertension, and stroke. RESULTS:Thirty-five percent of participants had a single diagnosed cardiovascular comorbidity, 25% had two, 12% had three, and 5% had four or more comorbidities. Between 1990 and 2007, the proportion of patients without any of these comorbidities decreased significantly, while the proportion of patients with multiple comorbidities increased significantly during the years under study. An increasing number of comorbidities was associated with higher 30-day and 1-year postadmission death rates in patients hospitalized with AMI. CONCLUSION:Patients hospitalized with AMI carry a significant burden of comorbid cardiovascular disease that adversely impacts their 30-day and longer-term survival. Increased attention to the management of AMI patients with multiple cardiovascular comorbidities is warranted.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:The CAnadian REgistry for Pulmonary Fibrosis (CARE-PF) is a multi-center, prospective registry designed to study the natural history of fibrotic interstitial lung disease (ILD) in adults. The aim of this cross-sectional sub-study was to describe the baseline characteristics, risk factors, and comorbidities of patients enrolled in CARE-PF to date. METHODS:Patients completed study questionnaires and clinical measurements at enrollment and each follow-up visit. Environmental exposures were assessed by patient self-report and comorbidities by the Charlson Comorbidity Index (CCI). Baseline characteristics, exposures, and comorbidities were described for the overall study population and for incident cases, and were compared across ILD subtypes. RESULTS:The full cohort included 1285 patients with ILD (961 incident cases (74.8%)). Diagnoses included connective tissue disease-associated ILD (33.3%), idiopathic pulmonary fibrosis (IPF) (24.7%), unclassifiable ILD (22.3%), chronic hypersensitivity pneumonitis (HP) (7.5%), sarcoidosis (3.2%), non-IPF idiopathic interstitial pneumonias (3.0%, including idiopathic nonspecific interstitial pneumonia (NSIP) in 0.9%), and other ILDs (6.0%). Patient-reported exposures were most frequent amongst chronic HP, but common across all ILD subtypes. The CCI was ≤2 in 81% of patients, with a narrow distribution and range of values. CONCLUSIONS:CTD-ILD, IPF, and unclassifiable ILD made up 80% of ILD diagnoses at ILD referral centers in Canada, while idiopathic NSIP was rare when adhering to recommended diagnostic criteria. CCI had a very narrow distribution across our cohort suggesting it may be a poor discriminator in assessing the impact of comorbidities on patients with ILD.

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