Predictors of mortality in patients with interstitial lung disease treated with corticosteroids: results from a cohort study.
Predictors of mortality in patients with interstitial lung disease treated with corticosteroids: results from a cohort study.
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DOI：
10.1097/md.0000000000000175
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发表时间：
2014-11
期刊：
影响因子：
1.6
通讯作者：
Tohma S
中科院分区：
文献类型：
--
作者：
Migita K;Arai T;Jiuchi Y;Izumi Y;Iwanaga N;Kawahara C;Suematsu E;Miyamura T;Tsutani H;Kawabe Y;Matsumura R;Mori S;Ohshima S;Yoshizawa S;Suenaga Y;Ogushi F;Kawabata M;Furukawa H;Matsui T;Bito S;Tohma S
间质性肺疾病（ILD）具有异质的临床表现，对这些患者的预后判断具有挑战性。我们研究了特发性间质性肺炎（IIPs）和结缔组织病相关间质性肺病（CTD-ILD）患者的临床特征和预后。我们对104例诊断为IIPs的患者和29例诊断为CTD-ILD的患者进行了一项多中心前瞻性研究，这些患者都是新诊断并最初使用皮质类固醇治疗的。我们比较了临床特征、高分辨率计算机断层扫描（HRCT）成像日期和结果。采用Cox比例风险回归分析确定与死亡风险增加相关的变量。生存率采用Kaplan-Meier法分析，log-rank检验评估。133例IIPs （n = 104）或CTD-ILD （n = 29）患者中，44例患者在随访期间死亡（平均：1.6±0.78年）。与CTD-ILD患者相比，IIPs患者的生存率似乎更差；然而，这种差异不显著（log-rank检验，P = 0.084）。在HRCT上，表现状态和明确的通常间质模式（UIP）在基线时对IIPs患者死亡率的重要预测指标较低。与非UIP患者相比，UIP患者的生存期更差。在HRCT上明确的UIP和较低的基线表现状态对iip患者的预后具有重要意义。
Interstitial lung disease (ILD) has a heterogeneous clinical presentation and establishing prognosis for these patients is challenging. We investigated the clinical characteristics and outcome of patients with idiopathic interstitial pneumonias (IIPs) and patients with connective tissue disease-associated interstitial lung disease (CTD-ILD). We conducted a multicenter prospective study on 104 patients diagnosed with IIPs and 29 patients diagnosed with CTD-ILD, which were newly diagnosed and treated with corticosteroids initially. We compared the clinical characteristics, high-resolution computed tomography (HRCT) imaging date, and outcomes. Cox proportional hazard regression analysis was used to identify variables with increased risk of death. Survival was analyzed according to the Kaplan–Meier method and was assessed with the log-rank test. Of 133 patients with IIPs (n = 104) or CTD-ILD (n = 29), 44 patients died during the follow-up period (mean: 1.6 ± 0.78 years). Patients with IIPs seemed to be associated with worse survival compared with those with CTD-ILD; however, this difference was not significant (log-rank test, P = 0.084). Significant predictors for mortality in patients with IIPs at baseline were lower for performance status and definite usual interstitial pattern (UIP) on HRCT. Patients with UIP experienced worse survival than those with non-UIP. A definite UIP on HRCT and lower baseline performance status have important prognostic implications in patients with IIPs.