6分钟步行试验优于其他特发性肺纤维化死亡率预测指标。一项来自瑞典IPF登记处的真实研究

Q2 Medicine Respiratory Medicine: X Pub Date : 2020-11-01 DOI:10.1016/j.yrmex.2020.100017

Ida Pesonen , Jing Gao , Dimitrios Kalafatis , Lisa Carlson , Magnus Sköld , Giovanni Ferrara

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引用次数: 9

摘要

背景和目的特发性肺纤维化(IPF)是一种以肺功能进行性丧失、限制性通气障碍和高5年死亡率为特征的疾病。我们的目的是在基线时描述IPF的临床特征，并评估哪些临床特征可以预测死亡率。方法:我们使用2014年1月至2018年10月从瑞典IPF登记处收集的基线数据。患者被随访了至少6个月。收集人口统计学、肺功能(用力肺活量(FVC)、总肺活量(TLC)、一氧化碳弥散量(DLCO%)、6分钟步行试验(6MWT)、6MWT期间最低血氧饱和度(L-SpO2)、King’s短暂间质性肺病健康状况问卷(K-BILD)评分。计算GAP指数和Charlson共病指数(CCI)。随访期间记录无移植生存。结果共纳入220例患者。在平均24个月的随访期间，57例(26%)死亡，6例(3%)接受了肺移植。在220例患者中，63例患者(29%)的FVC%等于或超过基线预测的80%。155例患者中只有17例(11%)TLC正常。在多变量cox回归模型中，经TLC%、K-BILD和GAP分期校正后，6MWT期间的步行距离是死亡/移植结局的独立预测因子(HR 0.80, 95%CI 0.65-0.99, p = 0.037)。结论我们的研究结果证实了6MWT作为IPF患者诊断时死亡率的主要预测因子的相关性。

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Six-minute walking test outweighs other predictors of mortality in idiopathic pulmonary fibrosis. A real-life study from the Swedish IPF registry

Background and objective

Idiopathic pulmonary fibrosis (IPF) is a disease characterized by a progressive loss of lung function, a restrictive ventilatory impairment, and a high five-year mortality. Our aim was to characterize clinical features of IPF at baseline and to assess which of those that would predict mortality.

Methods

We used baseline data at inclusion collected from the Swedish IPF registry between January 2014 and October 2018. Patients were followed for at least six months. Demographics, lung function (forced vital capacity (FVC), total lung capacity (TLC), diffusion capacity of carbon monoxide (DLCO%)), 6-min walking test (6MWT), lowest oxygen saturation during 6MWT (L-SpO₂), King's brief interstitial lung disease health status questionnaire (K-BILD) scores were collected. GAP index and Charlson Comorbidity Index (CCI) were calculated. Transplant-free survival was registered during the follow-up time.

Results

Two hundred and twenty patients were included in the study. Fifty-seven (26%) died and six (3%) underwent lung transplant during a mean follow-up time of 24 months. Out of 220 patients, 63 patients (29%) had a FVC% equal or over 80% of predicted at baseline. Only 17 out of 155 (11%) patients had a normal TLC%. Walking distance during a 6MWT was an independent predictor of outcome death/transplant (HR 0.80, 95%CI 0.65–0.99, p = 0.037), when adjusted for TLC%, K-BILD and GAP stage in a multivariate cox regression model.