Predictors for bronchoalveolar lavage recovery failure in diffuse parenchymal lung disease.
Predictors for bronchoalveolar lavage recovery failure in diffuse parenchymal lung disease.
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DOI：
10.1038/s41598-021-81313-5
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发表时间：
2021-01-18
影响因子：
4.6
通讯作者：
Suda T
中科院分区：
文献类型：
--
作者：
Koda K;Hozumi H;Yasui H;Suzuki Y;Karayama M;Furuhashi K;Enomoto N;Fujisawa T;Inui N;Nakamura Y;Suda T
支气管肺泡灌洗（BAL）在弥漫性肺实质疾病（DPLD）的诊断中起着重要作用;然而，较差的BALF（BALF）恢复导致诊断可靠性低。BAL是相对安全的，但在有风险的患者中应仔细考虑其适应症。因此，估计恢复失败的可能性有助于临床实践。本研究旨在阐明BALF恢复失败的预测因素，并建立其简单易用的预测模型。我们应用逻辑回归模型对401例DPLD患者（衍生队列）的临床、生理和放射学数据进行预测。使用这些因素的预测模型的判别性能进行了评估的c指数。在推导队列中，作为男性，1秒用力呼气量/用力肺活量和BAL靶部位而不是右中叶或左舌是独立的预测因子。我们开发的模型1和2的c指数分别为0.707和0.689。在234例患者的单独队列（验证队列）中，模型的c指数分别为0.689和0.670。总之，基于BALF恢复失败的独立预测因子，我们开发并成功验证了适用于考虑BAL适应症或靶部位的肺病学家的简单易用的预测模型。
Bronchoalveolar lavage (BAL) plays a role in the diagnosis of diffuse parenchymal lung diseases (DPLD); however, poor BAL fluid (BALF) recovery results in low diagnostic reliability. BAL is relatively safe, but its indications should be carefully considered in patients with risks. Therefore, estimating the likelihood of recovery failure is helpful in clinical practice. This study aimed to clarify predictors of BALF recovery failure and to develop its simple-to-use prediction models. We detected the predictors applying a logistic regression model on clinical, physiological, and radiological data from 401 patients with DPLD (derivation cohort). The discrimination performance of the prediction models using these factors was evaluated by the c-index. In the derivation cohort, being a man, the forced expiratory volume in one second/forced vital capacity, and a BAL target site other than right middle lobe or left lingula were independent predictors. The c-indices of models 1 and 2 that we developed were 0.707 and 0.689, respectively. In a separate cohort of 234 patients (validation cohort), the c-indices of the models were 0.689 and 0.670, respectively. In conclusion, we developed and successfully validated simple-to-use prediction models useful for pulmonologists considering BAL indications or target sites, based on independent predictors for BALF recovery failure.
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影响因子：
--
作者：
van den Hoogen, Frank;Khanna, Dinesh;Fransen, Jaap;Johnson, Sindhu R.;Baron, Murray;Tyndall, Alan;Matucci-Cerinic, Marco;Naden, Raymond P.;Medsger, Thomas A., Jr.;Carreira, Patricia E.;Riemekasten, Gabriela;Clements, Philip J.;Denton, Christopher P.;Distler, Oliver;Allanore, Yannick;Furst, Daniel E.;Gabrielli, Armando;Mayes, Maureen D.;van Laar, Jacob M.;Seibold, James R.;Czirjak, Laszlo;Steen, Virginia D.;Inanc, Murat;Kowal-Bielecka, Otylia;Mueller-Ladner, Ulf;Valentini, Gabriele;Veale, Douglas J.;Vonk, Madelon C.;Walker, Ulrich A.;Chung, Lorinda;Collier, David H.;Csuka, Mary Ellen;Fessler, Barri J.;Guiducci, Serena;Herrick, Ariane;Hsu, Vivien M.;Jimenez, Sergio;Kahaleh, Bashar;Merkel, Peter A.;Sierakowski, Stanislav;Silver, Richard M.;Simms, Robert W.;Varga, John;Pope, Janet E.
通讯作者：
Pope, Janet E.
影响因子：
24.3
作者：
Baughman, RP;Spencer, RE;Douthit, MM
通讯作者：
Douthit, MM
影响因子：
9.6
作者：
CANTIN, A;BEGIN, R;BOILEAU, R
通讯作者：
BOILEAU, R
影响因子：
1.6
作者：
Li, Yan;Dai, Yong-liang;Guo, You-min
通讯作者：
Guo, You-min
DOI：
10.1164/rccm.201202-0320st
发表时间：
2012-05-01
影响因子：
24.7
作者：
Meyer, Keith C.;Raghu, Ganesh;Wood, Brent
通讯作者：
Wood, Brent