Prognostic factors in combined pulmonary fibrosis and emphysema: a systematic review and meta-analysis

Background: Combined pulmonary fibrosis and emphysema (CPFE) is associated with high mortality, poor prognosis, and a substantial societal burden. This study aimed to identify and summarize prognostic factors in patients with CPFE through a systematic review and meta-analysis, with the goal of informing clinical management and treatment strategies. Methods: A systematic search was conducted in PubMed, Web of Science, the Cochrane Library, and Embase from database inception to August 15, 2025, to identify studies investigating prognostic factors in patients with CPFE. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). Hazard ratio (HR) with 95% confidence interval (CI) was used to determine prognostic factors for CPFE. Results: This study included 14 studies involving 1,874 patients. A meta-analysis of 10 studies, comprising 1,471 patients, demonstrated that age (HR =1.03; 95% CI: 1.02, 1.05; P