Prognostic Predictive Characteristics in Patients With Fibrosing Interstitial Lung Disease: A Retrospective Cohort...

Area of Science:

• Pulmonology
• Radiology
• Pathology

Background:

• Limited data exist on the full spectrum of interstitial lung diseases (ILD) with progressive fibrosing (PF) features.
• Understanding the prevalence and prognostic factors of PF-ILD is crucial for patient management.

Purpose of the Study:

• To investigate the prevalence of progressive fibrosing interstitial lung disease (PF-ILD).
• To identify clinical and imaging risk factors for fibrosis progression and mortality in PF-ILD patients.

Main Methods:

• Retrospective cohort study of fibrosing ILD patients from January 2015 to April 2021.
• Collected clinical data and outcomes to determine risk factors for progression and mortality.
• Utilized high-resolution computed tomography (HRCT) for pattern assessment.

Main Results:

• Of 579 fibrosing ILD patients, 227 (39.21%) showed progression.
• Risk factors for progression included finger clubbing (OR 1.52) and a UIP-like fibrotic pattern on HRCT (OR 1.95).
• Poor mortality was associated with hypoxemia (HR 2.08), low baseline diffusion capacity of the lung for carbon monoxide (DLCO) % predicted <50% (HR 2.25), and UIP-like fibrotic pattern (HR 1.68).

Conclusions:

• Finger clubbing and HRCT-identified UIP-like patterns are linked to progressive fibrosing disease.
• Prevalence varies by specific ILD diagnosis.
• Hypoxemia, reduced DLCO, and UIP-like patterns predict worse survival in PF-ILD patients.