{"title":"Predictive factors of progression in mild fibrosing interstitial lung disease patients with gender-age-physiology score of 3 or less.","authors":"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","doi":"10.1016/j.resinv.2024.12.005","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The prognostic factors in mild fibrosing interstitial lung disease (FILD) have not been established.</p><p><strong>Methods: </strong>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 (D<sub>LCO</sub>); 2, worsening of dyspnea; 3, worsening of fibrotic change on CT at 1 year after admission.</p><p><strong>Results: </strong>Univariate analysis showed that diagnosis of connective tissue disease-associated ILD, CT-definite usual interstitial pneumonia (UIP) pattern, composite physiologic index, FVC, D<sub>LCO</sub>, lowest SpO<sub>2</sub> and decrease in SpO<sub>2</sub>, 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 SpO<sub>2</sub> and decrease in SpO<sub>2</sub> in the 6MWT, and CAT score. In logistic regression analysis among 63 patients with non-IPF-ILD, diagnosis with fibrotic HP, lowest SpO<sub>2</sub> and decrease in SpO<sub>2</sub> in the 6MWT, and CAT score were also independent risk factors for annual FILD progression.</p><p><strong>Conclusions: </strong>Exercise-induced hypoxia, patient-reported outcome, radiological UIP pattern, and diagnosis with fibrotic HP are independent predictors of annual progression in mild FILD.</p>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"109-117"},"PeriodicalIF":2.4000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiratory investigation","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.resinv.2024.12.005","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/16 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
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.