Radiological and Physiological Predictors of IPF Mortality
<i>Background and Objectives</i>: Idiopathic pulmonary fibrosis (IPF) has a variable clinical course, which ranges from being asymptomatic to progressive respiratory failure. The purpose of this study was to evaluate the novel clinical parameters of IPF patients who receive an anti-fibro...
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| Format: | Article |
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MDPI AG
2021-10-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/57/10/1121 |
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| author | Tomoo Kishaba Akiko Maeda Shoshin Yamazato Daijiro Nabeya Shin Yamashiro Hiroaki Nagano |
| author_facet | Tomoo Kishaba Akiko Maeda Shoshin Yamazato Daijiro Nabeya Shin Yamashiro Hiroaki Nagano |
| author_sort | Tomoo Kishaba |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Idiopathic pulmonary fibrosis (IPF) has a variable clinical course, which ranges from being asymptomatic to progressive respiratory failure. The purpose of this study was to evaluate the novel clinical parameters of IPF patients who receive an anti-fibrotic agent. <i>Materials and Methods</i>: From January 2011 to January 2021, we identified 39 IPF patients at Okinawa Chubu Hospital. Clinical information was obtained, such as laboratory data, pulmonary function test (PFT) results, and chest images, including of soft tissue thickness and the high-resolution computed tomography (HRCT) pattern at diagnosis. <i>Results:</i> The mean age was 72.9 ± 7.0 (53–85); 27 patients were men and 12 were women. The mean body mass index was 25.1 ± 3.9 (17.3–35). Twenty-four were active smokers and the median number of packs per year was 20. Regarding laboratory findings, mean white blood cell (WBC), lactate dehydrogenase (LDH), and Krebs Von den Lungen-6 (KL-6) values were 7816 ± 1859, 248 ± 47, and 1615 ± 1503, respectively. In PFT, the mean percent predicted FVC, percent predicted total lung capacity, percent predicted functional residual capacity (FRC), and percent predicted diffusion capacity of the lung for carbon monoxide (DLco) were 66.8 ± 14.9%, 71.8 ± 13.7%, 65 ± 39.6%, and 64.6 ± 27.9%, respectively. In chest radiological findings, soft tissue thickness at the right 9th rib was 26.4 ± 8.8 mm. Regarding chest HRCT patterns, 15 showed the definite usual interstitial pneumonia (UIP) pattern, 16 showed the probable UIP pattern, and eight showed the indeterminate for UIP pattern. In the treatment, 24 patients received pirfenidone and 15 patients took nintedanib. The mean observation period was 38.6 ± 30.6 months and 24 patients died. The median survival time was 32.4 months (0.9–142.5). Multivariate analysis adjusted for age showed that both soft tissue thickness [Hazard ratio (HR): 0.912, 95% confidence interval (CI): 0.859–0.979, <i>p</i>-value: 0.009] and percent FRC [HR: 0.980, 95% CI: 0.967–0.992, <i>p</i>-value: 0.002] were robust predictors of IPF mortality. <i>Conclusions:</i> In IPF patients treated with anti-fibrotic agents, both soft tissue thickness at the right 9th rib shown on the chest radiograph and %FRC can be novel predictors of IPF mortality. |
| first_indexed | 2024-03-10T06:23:39Z |
| format | Article |
| id | doaj.art-0cf0ea08088f45c391aa1ee1976cd9a1 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T06:23:39Z |
| publishDate | 2021-10-01 |
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| series | Medicina |
| spelling | doaj.art-0cf0ea08088f45c391aa1ee1976cd9a12023-11-22T19:05:16ZengMDPI AGMedicina1010-660X1648-91442021-10-015710112110.3390/medicina57101121Radiological and Physiological Predictors of IPF MortalityTomoo Kishaba0Akiko Maeda1Shoshin Yamazato2Daijiro Nabeya3Shin Yamashiro4Hiroaki Nagano5Department of Respiratory Medicine, Okinawa Chubu Hospital, Okinawa 904-2293, JapanDepartment of Respiratory Medicine, Iizuka Hospital, Fukuoka 820-8505, JapanDepartment of Respiratory Medicine, Okinawa Chubu Hospital, Okinawa 904-2293, JapanDepartment of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, JapanDepartment of Respiratory Medicine, Okinawa Chubu Hospital, Okinawa 904-2293, JapanDepartment of Respiratory Medicine, Okinawa Chubu Hospital, Okinawa 904-2293, Japan<i>Background and Objectives</i>: Idiopathic pulmonary fibrosis (IPF) has a variable clinical course, which ranges from being asymptomatic to progressive respiratory failure. The purpose of this study was to evaluate the novel clinical parameters of IPF patients who receive an anti-fibrotic agent. <i>Materials and Methods</i>: From January 2011 to January 2021, we identified 39 IPF patients at Okinawa Chubu Hospital. Clinical information was obtained, such as laboratory data, pulmonary function test (PFT) results, and chest images, including of soft tissue thickness and the high-resolution computed tomography (HRCT) pattern at diagnosis. <i>Results:</i> The mean age was 72.9 ± 7.0 (53–85); 27 patients were men and 12 were women. The mean body mass index was 25.1 ± 3.9 (17.3–35). Twenty-four were active smokers and the median number of packs per year was 20. Regarding laboratory findings, mean white blood cell (WBC), lactate dehydrogenase (LDH), and Krebs Von den Lungen-6 (KL-6) values were 7816 ± 1859, 248 ± 47, and 1615 ± 1503, respectively. In PFT, the mean percent predicted FVC, percent predicted total lung capacity, percent predicted functional residual capacity (FRC), and percent predicted diffusion capacity of the lung for carbon monoxide (DLco) were 66.8 ± 14.9%, 71.8 ± 13.7%, 65 ± 39.6%, and 64.6 ± 27.9%, respectively. In chest radiological findings, soft tissue thickness at the right 9th rib was 26.4 ± 8.8 mm. Regarding chest HRCT patterns, 15 showed the definite usual interstitial pneumonia (UIP) pattern, 16 showed the probable UIP pattern, and eight showed the indeterminate for UIP pattern. In the treatment, 24 patients received pirfenidone and 15 patients took nintedanib. The mean observation period was 38.6 ± 30.6 months and 24 patients died. The median survival time was 32.4 months (0.9–142.5). Multivariate analysis adjusted for age showed that both soft tissue thickness [Hazard ratio (HR): 0.912, 95% confidence interval (CI): 0.859–0.979, <i>p</i>-value: 0.009] and percent FRC [HR: 0.980, 95% CI: 0.967–0.992, <i>p</i>-value: 0.002] were robust predictors of IPF mortality. <i>Conclusions:</i> In IPF patients treated with anti-fibrotic agents, both soft tissue thickness at the right 9th rib shown on the chest radiograph and %FRC can be novel predictors of IPF mortality.https://www.mdpi.com/1648-9144/57/10/1121IPFanti-fibrotic agent%FRCsoft tissue thicknessmortality |
| spellingShingle | Tomoo Kishaba Akiko Maeda Shoshin Yamazato Daijiro Nabeya Shin Yamashiro Hiroaki Nagano Radiological and Physiological Predictors of IPF Mortality Medicina IPF anti-fibrotic agent %FRC soft tissue thickness mortality |
| title | Radiological and Physiological Predictors of IPF Mortality |
| title_full | Radiological and Physiological Predictors of IPF Mortality |
| title_fullStr | Radiological and Physiological Predictors of IPF Mortality |
| title_full_unstemmed | Radiological and Physiological Predictors of IPF Mortality |
| title_short | Radiological and Physiological Predictors of IPF Mortality |
| title_sort | radiological and physiological predictors of ipf mortality |
| topic | IPF anti-fibrotic agent %FRC soft tissue thickness mortality |
| url | https://www.mdpi.com/1648-9144/57/10/1121 |
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