Prognostic classification in acute exacerbation of idiopathic pulmonary fibrosis: a multicentre retrospective cohort study

Acute exacerbation (AE) in idiopathic pulmonary fibrosis (IPF) is a major prognostic determinant. However, evidence for its prognostic strength is mainly based on the results of small cohort studies with statistical limitations. This retrospective study, which included 108 patients with a first epis...

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Veröffentlicht in:Scientific reports 2021-04, Vol.11 (1), p.9120-9120, Article 9120
Hauptverfasser: Suzuki, Takahito, Hozumi, Hironao, Miyashita, Koichi, Kono, Masato, Suzuki, Yuzo, Karayama, Masato, Furuhashi, Kazuki, Hasegawa, Hirotsugu, Fujisawa, Tomoyuki, Enomoto, Noriyuki, Nakamura, Yutaro, Inui, Naoki, Yokomura, Koshi, Nakamura, Hidenori, Suda, Takafumi
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Sprache:eng
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Zusammenfassung:Acute exacerbation (AE) in idiopathic pulmonary fibrosis (IPF) is a major prognostic determinant. However, evidence for its prognostic strength is mainly based on the results of small cohort studies with statistical limitations. This retrospective study, which included 108 patients with a first episode of AE-IPF, aimed to identify prognostic factors and to develop prognostic classification models. Multivariate Cox regression analysis revealed that a lower percent-predicted forced vital capacity within 12 months before AE onset (baseline %FVC) and a lower PaO 2 /FiO 2 ratio at AE onset were independent mortality predictors. If the value of each predictor was lower than the cutoff determined by receiver-operating characteristic analysis, 1 point was assigned. Classification of patients into mild, moderate, and severe groups based on total score showed post-AE 90-day cumulative survival rates of 83.3%, 66.2%, and 22.2%, respectively (model 1: C-index 0.702). Moreover, a decision tree-based model was created with the recursive partitioning method using baseline %FVC and PaO 2 /FiO 2 ratio at AE onset from among multivariable; accordingly, patients were classified into 3 groups with post-AE 90-day cumulative survival rates of 84.1%, 64.3%, and 24.0%, respectively (model 2: C-index 0.735). These models can guide clinicians in determining therapeutic strategies and help design future studies on AE-IPF.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-021-88718-2