Prognostic implications of physiologic and radiographic changes in idiopathic interstitial pneumonia

Kevin R. Flaherty, Jeanette A. Mumford, Susan Murray, Ella A. Kazerooni, Barry H. Gross, Thomas V. Colby, William D. Travis, Andrew Flint, Galen B. Toews, Joseph P. Lynch, Fernando J. Martinez

Research output: Contribution to journalArticle

385 Scopus citations

Abstract

Idiopathic interstitial pneumonias are a diverse group of lung diseases with varied prognoses. We hypothesized that changes in physiologic and radiographic parameters would predict survival. We retrospectively examined 80 patients with usual interstitial pneumonia and 29 patients with nonspecific interstitial pneumonia. Baseline characteristics were examined together with 6-month change in forced vital capacity, diffusing capacity for carbon monoxide, and ground glass infiltrate and fibrosis on high resolution computed tomography. Patients with usual interstitial pneumonia were more likely to have a statistically significant or marginally significant decline in lung volume, diffusing capacity for carbon monoxide, and an increase in ground glass infiltrates (p ≤ 0.08) compared with patients with nonspecific interstitial pneumonia. For patients with usual interstitial pneumonia, change in forced vital capacity was the best physiologic predictor of mortality (p = 0.05). In a multivariate Cox proportional hazards model controlling for histopathologic diagnosis, gender, smoking history, baseline forced vital capacity, and 6-month change in forced vital capacity, a decrease in forced vital capacity remained an independent risk factor for mortality (decrease > 10%; hazard ratio 2.47; 95% confidence interval 1.29, 4.73; p = 0.006). We conclude that a 6-month change in forced vital capacity gives additional prognostic information to baseline features for patients with idiopathic interstitial pneumonia.

Original languageEnglish (US)
Pages (from-to)543-548
Number of pages6
JournalAmerican journal of respiratory and critical care medicine
Volume168
Issue number5
DOIs
StatePublished - Sep 1 2003

Keywords

  • Idiopathic pulmonary fibrosis
  • Nonspecific interstitial pneumonia
  • Pulmonary function
  • Serial testing
  • Usual interstitial pneumonia

ASJC Scopus subject areas

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

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    Flaherty, K. R., Mumford, J. A., Murray, S., Kazerooni, E. A., Gross, B. H., Colby, T. V., Travis, W. D., Flint, A., Toews, G. B., Lynch, J. P., & Martinez, F. J. (2003). Prognostic implications of physiologic and radiographic changes in idiopathic interstitial pneumonia. American journal of respiratory and critical care medicine, 168(5), 543-548. https://doi.org/10.1164/rccm.200209-1112OC