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Updated: Nov 29, 2025
Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Clinical utility of a composite scoring system including Charlson Comorbidity Index score in patients with
Hiroyuki Yagyu1, Kota Murohashi1, Yu Hara1
1Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Insights
A new scoring system combining idiopathic pulmonary fibrosis (IPF) diagnosis, Charlson Comorbidity Index score (CCIS), and diffusion capacity (%DLco) helps predict 3-year prognosis in interstitial lung disease (ILD) patients.
Area of Science:
- Pulmonology
- Internal Medicine
- Medical Prognostics
Background:
- Prognostic factors for interstitial lung disease (ILD) are not well-established.
- The utility of the Charlson Comorbidity Index score (CCIS) in predicting ILD prognosis requires clarification.
Purpose of the Study:
- To evaluate if the Charlson Comorbidity Index score (CCIS) can predict disease prognosis in patients with interstitial lung disease (ILD).
Main Methods:
- Retrospective assessment of 180 ILD patients (April 2013-April 2017).
- Analysis of baseline clinical parameters, including CCIS, ILD diagnosis, and pulmonary function tests (%DLco).
- Evaluation of 3-year ILD-related events: cause-specific death and acute exacerbations (AE).
Main Results:
- A composite scoring system including idiopathic pulmonary fibrosis (IPF) diagnosis, CCIS, and %DLco achieved a C-index of 0.825 for predicting 3-year ILD events.
- CCIS, %DLco, and IPF diagnosis were the most significant contributors in the prognostic nomogram.
- The study included patients with IPF, iNSIP, connective tissue disease-related ILD, and chronic hypersensitivity pneumonia (CHP).
Conclusions:
- A composite scoring system incorporating IPF diagnosis, CCIS, and %DLco offers a valuable tool for predicting prognosis in ILD patients.
- This tool is particularly useful for patients with relatively mild ILD who can tolerate pulmonary diffusion capacity testing.
Background:
Prognostic factors have yet to be established for patients with interstitial lung disease (ILD). We aimed to clarify whether the Charlson Comorbidity Index score (CCIS) could help predict disease prognosis in patients with ILD.
Methods:
Among ILD patients treated between April 2013 and April 2017, we retrospectively assessed the relationship between baseline clinical parameters including age, sex, CCIS, ILD diagnosis, pulmonary function test results, and 3-year ILD-related events including cause-specific death and first acute exacerbation (AE).
Results:
We assessed 180 patients (mean age, 74 years), all of whom underwent pulmonary function testing including percentage predicted diffusion capacity for carbon monoxide (%DLco). Underlying pathologies included idiopathic pulmonary fibrosis (IPF) in 57 cases, idiopathic nonspecific interstitial pneumonia (iNSIP) and collagen vascular disease-related interstitial pneumonia in 117 cases, and chronic hypersensitivity pneumonia (CHP) in 6 cases. A composite scoring system comprising IPF diagnosis, CCIS, and %DLco provided a favorable C-index (0.825) for predicting 3-year ILD-related events. The nomogram for 3-year prognosis revealed the largest contributions from CCIS, %DLco and IPF diagnosis.
Conclusions:
This composite scoring system accounting for IPF diagnosis, CCIS, and %DLco could provide a useful tool for predicting prognosis in relatively mild ILD patients tolerated to pulmonary diffusion capacity testing.
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