Jin Wook Lee1, Esmeralda Shehu2, Juarda Gjonbrataj3, Young Eun Bahn4, Byung Hak Rho4, Mi-Young Lee5, Won-Il Choi6. 1. Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea. 2. Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea; Department of Internal Medicine, Regional Hospital of Durres, Albania. 3. Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea; Department of Internal Medicine, Mother Theresa University Hospital, Tirana, Albania. 4. Department of Radiology, Keimyung University School of Medicine, Daegu, Republic of Korea. 5. Preventive Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea. 6. Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea. Electronic address: wichoi@dsmc.or.kr.
Abstract
BACKGROUND: Patients with possible usual interstitial pneumonia (UIP) constitute a substantial group, and their clinical characteristics and outcomes are not well defined. We compared the clinical characteristics and survival between patients with possible UIP and the UIP pattern. METHODS: We evaluated 62 patients with possible UIP and 544 patients with the UIP pattern. Both groups were diagnosed by clinical characteristics and high-resolution computed tomography (HRCT) findings. Two radiologists performed radiological evaluation based on the new idiopathic pulmonary fibrosis (IPF) guidelines. Two risk-stratification methods were used to compare UIP pattern and possible UIP patients. RESULTS: The groups had similar demographic and clinical characteristics. Pulmonary function tests revealed no significant differences in lung volumes between the 2 groups. However, DLCO was significantly lower with the UIP pattern than with possible UIP (p = 0.004). Multivariate analysis showed age, sex, and carbon monoxide diffusing capacity (DLCO) as important independent variables for survival. The UIP HRCT pattern did not affect survival (hazard ratio, 0.83; 95% confidence interval, 0.51-1.24; p = 0.32). Possible UIP was not associated with prognosis when independent predictors for survival rate and propensity score were considered. In the case-control study, the 3-year survival rate was 44.6% in the UIP pattern group and 56.8% in the possible UIP group (p = 0.16). CONCLUSIONS: Clinical characteristics and outcomes were similar in possible UIP and UIP patients, except for differences in DLCO. The UIP pattern itself did not affect survival.
BACKGROUND:Patients with possible usual interstitial pneumonia (UIP) constitute a substantial group, and their clinical characteristics and outcomes are not well defined. We compared the clinical characteristics and survival between patients with possible UIP and the UIP pattern. METHODS: We evaluated 62 patients with possible UIP and 544 patients with the UIP pattern. Both groups were diagnosed by clinical characteristics and high-resolution computed tomography (HRCT) findings. Two radiologists performed radiological evaluation based on the new idiopathic pulmonary fibrosis (IPF) guidelines. Two risk-stratification methods were used to compare UIP pattern and possible UIP patients. RESULTS: The groups had similar demographic and clinical characteristics. Pulmonary function tests revealed no significant differences in lung volumes between the 2 groups. However, DLCO was significantly lower with the UIP pattern than with possible UIP (p = 0.004). Multivariate analysis showed age, sex, and carbon monoxide diffusing capacity (DLCO) as important independent variables for survival. The UIP HRCT pattern did not affect survival (hazard ratio, 0.83; 95% confidence interval, 0.51-1.24; p = 0.32). Possible UIP was not associated with prognosis when independent predictors for survival rate and propensity score were considered. In the case-control study, the 3-year survival rate was 44.6% in the UIP pattern group and 56.8% in the possible UIP group (p = 0.16). CONCLUSIONS: Clinical characteristics and outcomes were similar in possible UIP and UIP patients, except for differences in DLCO. The UIP pattern itself did not affect survival.
Authors: Margaret L Salisbury; Leslie B Tolle; Meng Xia; Susan Murray; Nabihah Tayob; Anoop M Nambiar; Shelley L Schmidt; Amir Lagstein; Jeffery L Myers; Barry H Gross; Ella A Kazerooni; Baskaran Sundaram; Aamer R Chughtai; Fernando J Martinez; Kevin R Flaherty Journal: Respir Med Date: 2017-09-12 Impact factor: 3.415
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Authors: Ganesh Raghu; Athol U Wells; Andrew G Nicholson; Luca Richeldi; Kevin R Flaherty; Florence Le Maulf; Susanne Stowasser; Rozsa Schlenker-Herceg; David M Hansell Journal: Am J Respir Crit Care Med Date: 2017-01-01 Impact factor: 21.405