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

205 Citations (Scopus)

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
Externally publishedYes

Fingerprint

Interstitial Lung Diseases
Idiopathic Pulmonary Fibrosis
Pathology
Survival
Lung
Idiopathic Interstitial Pneumonias
Multivariate Analysis

Keywords

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

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Physiology is a stronger predictor of survival than pathology in fibrotic interstitial pneumonia. / Jegal, Yangjin; Dong, Soon Kim; Tae, Sun Shim; Lim, Chae Man; Sang, Do Lee; Koh, Younsuck; Woo, Sung Kim; Won, Dong Kim; Jin, Seong Lee; Travis, William D.; Kitaichi, Masanori; Colby, Thomas V.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 171, No. 6, 15.03.2005, p. 639-644.

Research output: Contribution to journalArticle

Jegal, Y, Dong, SK, Tae, SS, Lim, CM, Sang, DL, Koh, Y, Woo, SK, Won, DK, Jin, SL, Travis, WD, Kitaichi, M & Colby, TV 2005, 'Physiology is a stronger predictor of survival than pathology in fibrotic interstitial pneumonia', American Journal of Respiratory and Critical Care Medicine, vol. 171, no. 6, pp. 639-644. https://doi.org/10.1164/rccm.200403-331OC
Jegal, Yangjin ; Dong, Soon Kim ; Tae, Sun Shim ; Lim, Chae Man ; Sang, Do Lee ; Koh, Younsuck ; Woo, Sung Kim ; Won, Dong Kim ; Jin, Seong Lee ; Travis, William D. ; Kitaichi, Masanori ; Colby, Thomas V. / Physiology is a stronger predictor of survival than pathology in fibrotic interstitial pneumonia. In: American Journal of Respiratory and Critical Care Medicine. 2005 ; Vol. 171, No. 6. pp. 639-644.
@article{8f706b27c69d42dba7c94eac83b65f93,
title = "Physiology is a stronger predictor of survival than pathology in fibrotic interstitial pneumonia",
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.",
keywords = "Fibrotic nonspecific interstitial pneumonia, Idiopathic pulmonary fibrosis, Prognostic factor, Pulmonary function, Surgical lung biopsy",
author = "Yangjin Jegal and Dong, {Soon Kim} and Tae, {Sun Shim} and Lim, {Chae Man} and Sang, {Do Lee} and Younsuck Koh and Woo, {Sung Kim} and Won, {Dong Kim} and Jin, {Seong Lee} and Travis, {William D.} and Masanori Kitaichi and Colby, {Thomas V.}",
year = "2005",
month = "3",
day = "15",
doi = "10.1164/rccm.200403-331OC",
language = "English (US)",
volume = "171",
pages = "639--644",
journal = "American Journal of Respiratory and Critical Care Medicine",
issn = "1073-449X",
publisher = "American Thoracic Society",
number = "6",

}

TY - JOUR

T1 - Physiology is a stronger predictor of survival than pathology in fibrotic interstitial pneumonia

AU - Jegal, Yangjin

AU - Dong, Soon Kim

AU - Tae, Sun Shim

AU - Lim, Chae Man

AU - Sang, Do Lee

AU - Koh, Younsuck

AU - Woo, Sung Kim

AU - Won, Dong Kim

AU - Jin, Seong Lee

AU - Travis, William D.

AU - Kitaichi, Masanori

AU - Colby, Thomas V.

PY - 2005/3/15

Y1 - 2005/3/15

N2 - 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.

AB - 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.

KW - Fibrotic nonspecific interstitial pneumonia

KW - Idiopathic pulmonary fibrosis

KW - Prognostic factor

KW - Pulmonary function

KW - Surgical lung biopsy

UR - http://www.scopus.com/inward/record.url?scp=20144381640&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=20144381640&partnerID=8YFLogxK

U2 - 10.1164/rccm.200403-331OC

DO - 10.1164/rccm.200403-331OC

M3 - Article

VL - 171

SP - 639

EP - 644

JO - American Journal of Respiratory and Critical Care Medicine

JF - American Journal of Respiratory and Critical Care Medicine

SN - 1073-449X

IS - 6

ER -