Predictive factors of progression in mild fibrosing interstitial lung disease patients with gender-age-physiology score of 3 or less.

IF 2.4 Q2 RESPIRATORY SYSTEM Respiratory investigation Pub Date : 2025-01-01 Epub Date: 2024-12-16 DOI:10.1016/j.resinv.2024.12.005
Masaki Okamoto, Kiminori Fujimoto, Tomonori Chikasue, Toyoshi Yanagihara, Kazuhiro Tabata, Yoshiaki Zaizen, Masaki Tominaga, Akiko Sumi, Hiroaki Takeoka, Norikazu Matsuo, Takashi Nouno, Atsushi Kawaguchi, Tomoaki Hoshino
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Abstract

Background: The prognostic factors in mild fibrosing interstitial lung disease (FILD) have not been established.

Methods: We retrospectively attempted to identify predictive factors of annual progression in mild FILD with gender-age-physiology (GAP) score of 3 or less using logistic regression analysis. Annual FILD progression was defined as meeting any two or more of the following conditions: 1, more than 10% decrease in forced vital capacity (FVC) or 15% decrease in diffusing capacity of the lungs for carbon monoxide (DLCO); 2, worsening of dyspnea; 3, worsening of fibrotic change on CT at 1 year after admission.

Results: Univariate analysis showed that diagnosis of connective tissue disease-associated ILD, CT-definite usual interstitial pneumonia (UIP) pattern, composite physiologic index, FVC, DLCO, lowest SpO2 and decrease in SpO2, and walk distance in the 6-minutes walk test (6MWT), chronic pulmonary emphysema assessment test (CAT) score, and some variables in Short-Form 36 were significantly associated with incidence of annual progression. Multivariate analysis showed that independent predictive factors were diagnosis of idiopathic pulmonary fibrosis (IPF) and fibrotic hypersensitivity pneumonitis (HP), CT-definite UIP pattern, lowest SpO2 and decrease in SpO2 in the 6MWT, and CAT score. In logistic regression analysis among 63 patients with non-IPF-ILD, diagnosis with fibrotic HP, lowest SpO2 and decrease in SpO2 in the 6MWT, and CAT score were also independent risk factors for annual FILD progression.

Conclusions: Exercise-induced hypoxia, patient-reported outcome, radiological UIP pattern, and diagnosis with fibrotic HP are independent predictors of annual progression in mild FILD.

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背景:轻度纤维化间质性肺病(FILD)的预后因素尚未确定:轻度纤维化间质性肺病(FILD)的预后因素尚未确定:我们采用逻辑回归分析法,回顾性地尝试找出性别-年龄-生理学(GAP)评分为 3 分或更低的轻度 FILD 年度进展的预测因素。每年的 FILD 进展被定义为满足以下任何两个或两个以上条件:1、用力肺活量(FVC)下降超过 10%,或一氧化碳肺弥散容量(DLCO)下降超过 15%;2、呼吸困难加重;3、入院 1 年后 CT 纤维化改变加重:单变量分析表明,结缔组织病相关性 ILD 诊断、CT 定义的寻常间质性肺炎(UIP)模式、综合生理指数、FVC、DLCO、最低 SpO2 和 SpO2 下降、6 分钟步行测试(6MWT)步行距离、慢性肺气肿评估测试(CAT)评分以及短表 36 中的一些变量与年进展发生率显著相关。多变量分析表明,特发性肺纤维化(IPF)和纤维化超敏性肺炎(HP)的诊断、CT-无限UIP模式、6MWT最低SpO2和SpO2下降以及CAT评分是独立的预测因素。在对63名非IPF-ILD患者进行的逻辑回归分析中,纤维化HP诊断、6MWT中最低SpO2和SpO2下降以及CAT评分也是FILD年度进展的独立风险因素:运动引起的缺氧、患者报告的结果、放射学 UIP 模式和纤维化 HP 诊断是轻度 FILD 年度进展的独立预测因素。
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来源期刊
Respiratory investigation
Respiratory investigation RESPIRATORY SYSTEM-
CiteScore
4.90
自引率
6.50%
发文量
114
审稿时长
64 days
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