Physiology is a stronger predictor of survival than pathology in fibrotic interstitial pneumonia

Yangjin Jegal, Soon Kim Dong, Sun Shim Tae, Chae Man Lim, Do Lee Sang, Younsuck Koh, Sung Kim Woo, Dong Kim Won, Seong Lee Jin, William D. Travis, Masanori Kitaichi, Thomas V. Colby

Research output: Contribution to journalArticle

209 Scopus citations

Abstract

The histopathologic pattern provides the most important prognostic marker for idiopathic interstitial pneumonia; however, studies have suggested that short-term changes in lung function may be more important. We investigated the prognostic factors for fibrotic interstitial pneumonia. The clinical features and follow-up course of 179 patients (131 with idiopathic pulmonary fibrosis and 48 with nonspecific interstitial pneumonia; 41 fibrotic types and 7 cellular) were analyzed retrospectively. The lung function indices improved or stabilized in most patients with fibrotic nonspecific interstitial pneumonia in contrast to the deterioration or stable condition of most patients with idiopathic pulmonary fibrosis. The 5-year survival of patients with fibrotic nonspecific interstitial pneumonia (76.2%) was better than for those with idiopathic pulmonary fibrosis (43.8%) (p = 0.007). Multivariate analysis at the time of presentation revealed that pathologic pattern, age, and diffusion capacity had important prognostic implications. However, after 6 months of follow-up, changes in FVC, initial diffusion capacity, and sex were the only independent prognostic factors, with no additional prognostic information conferred by the histologic diagnosis. Our data confirmed the importance of physiological parameters including short-term change in FVC. However, at the time of diagnosis, histopathology was important for the prediction of prognosis and future change in lung function.

Original languageEnglish (US)
Pages (from-to)639-644
Number of pages6
JournalAmerican journal of respiratory and critical care medicine
Volume171
Issue number6
DOIs
StatePublished - Mar 15 2005

    Fingerprint

Keywords

  • Fibrotic nonspecific interstitial pneumonia
  • Idiopathic pulmonary fibrosis
  • Prognostic factor
  • Pulmonary function
  • Surgical lung biopsy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Jegal, Y., Dong, S. K., Tae, S. S., Lim, C. M., Sang, D. L., Koh, Y., Woo, S. K., Won, D. K., Jin, S. L., Travis, W. D., Kitaichi, M., & Colby, T. V. (2005). Physiology is a stronger predictor of survival than pathology in fibrotic interstitial pneumonia. American journal of respiratory and critical care medicine, 171(6), 639-644. https://doi.org/10.1164/rccm.200403-331OC