Clinical Predictors of Survival in Idiopathic Pulmonary Fibrosis

被引:27
作者
Kim, Ji Hye [1 ]
Lee, Jin Hwa [1 ]
Ryu, Yon Ju [1 ]
Chang, Jung Hyun [1 ]
机构
[1] Ewha Womans Univ, Sch Med, Dept Internal Med, 911-1 Mok 5 Dong, Seoul 158710, South Korea
关键词
Idiopathic Pulmonary Fibrosis; Body Mass Index; Disease Progression;
D O I
10.4046/trd.2012.73.3.162
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Background: Idiopathic pulmonary fibrosis (IPF) is a progressive disease. Effective treatment is not currently available and the prognosis is poor. The aim of our study was to identify clinical predictors of survival in patients with IPF. Methods: By using medical record database of a university hospital, we reviewed the records of patients who had been diagnosed as having IPF from January 1996 through December 2007. Results: Among 89 patients considered as having interstitial lung disease (ILD) on computed tomography (CT) of the chest, 22 were excluded because of the diagnosis of other ILDs or connective tissue disease, and finally, 67 met the criteria of IPF. The mean age at the diagnosis of IPF was 70 years (range, 41 similar to 87 years) and 43 (64%) were male. The mean survival time following the diagnosis of IPF was 40 months (range, 0 similar to 179 months). Among them, 28 cases were diagnosed as the progressive state of IPF on the follow-up CT examination, and the mean duration between diagnosis of IPF and progression was 31 months. Multivariate analysis using Cox regression model revealed that body mass index (BMI) less than 18.5 kg/m(2) (p=0.030; hazard ratio [HR], 12.085; 95% confidence interval [CI], 1.277 similar to 114.331) and CT progression before 36 months from the diagnosis of IPF (p=0.042; HR, 13.564; 95% CI, 1.101 similar to 167.166) were independently associated with mortality. Conclusion: Since low BMI at the diagnosis of IPF and progression on follow-up CT were associated with poor prognosis, IPF patients with low BMI and/or progression before 36 months following the diagnosis should be closely monitored.
引用
收藏
页码:162 / 168
页数:7
相关论文
共 39 条
[1]   CT findings during phase of accelerated deterioration in patients with idiopathic pulmonary fibrosis [J].
Akira, M ;
Hamada, H ;
Sakatani, M ;
Kobayashi, C ;
Nishioka, M ;
Yamamoto, S .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1997, 168 (01) :79-83
[2]   Body mass index and mortality in patients with idiopathic pulmonary fibrosis [J].
Alakhras, Mazen ;
Decker, Paul A. ;
Nadrous, Hassan F. ;
Collazo-Clavell, Maria ;
Ryu, Jay H. .
CHEST, 2007, 131 (05) :1448-1453
[3]  
Ambrosini V, 2003, EUR RESPIR J, V22, P821, DOI 10.1183/09031936.03.00022703
[4]  
American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias, 2001, AM J RESP CRIT CARE, V165, P277, DOI [10.1164/ajrccm.165.2.ats01, DOI 10.1164/AJRCCM.165.2.ATS01]
[6]   Echocardiographic assessment of pulmonary hypertension in patients with advanced lung disease [J].
Arcasoy, SM ;
Christie, JD ;
Ferrari, VA ;
Sutton, MS ;
Zisman, DA ;
Blumenthal, NP ;
Pochettino, A ;
Kotloff, RM .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2003, 167 (05) :735-740
[7]   Double-blind, placebo-controlled trial of pirfenidone in patients with idiopathic pulmonary fibrosis [J].
Azuma, A ;
Nukiwa, T ;
Tsuboi, E ;
Suga, M ;
Abe, S ;
Nakata, K ;
Taguchi, Y ;
Nagai, S ;
Itoh, H ;
Ohi, M ;
Sato, A ;
Kudoh, S ;
Raghu, G .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2005, 171 (09) :1040-1047
[8]   Prognostic significance of histopathologic subsets in idiopathic pulmonary fibrosis [J].
Bjoraker, JA ;
Ryu, JH ;
Edwin, MK ;
Myers, JL ;
Tazelaar, HD ;
Schroeder, DR ;
Offord, KP .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1998, 157 (01) :199-203
[9]   C-reactive protein and body mass index predict outcome in end-stage respiratory failure [J].
Cano, NJM ;
Pichard, C ;
Roth, H ;
Court-Fortuné, I ;
Cynober, L ;
Gérard-Boncompain, M ;
Cuvelier, A ;
Laaban, JP ;
Melchior, JC ;
Raphaël, JC ;
Pison, CM .
CHEST, 2004, 126 (02) :540-546
[10]   Changes in clinical and physiologic variables predict survival in idiopathic pulmonary fibrosis [J].
Collard, HR ;
King, TE ;
Bartelson, BB ;
Vourlekis, JS ;
Schwarz, MI ;
Brown, KK .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2003, 168 (05) :538-542