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Fibrotic idiopathic interstitial pneumonia: the prognostic value of longitudinal functional trends.
Am J Respir Crit Care Med. 2003 Sep 01; 168(5):531-7.AJ

Abstract

Survival is linked to the histopathologic distinction between usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP), the most commonly encountered fibrotic idiopathic interstitial pneumonia. We retrospectively compared the prognostic significance of histopathologic diagnoses, baseline pulmonary function indices, and serial trends in pulmonary function indices (diffusing capacity, FVC, FEV1, the recently defined composite physiologic index) at 6 and 12 months in 104 patients (UIP, n = 63; fibrotic NSIP, n = 41). Survival was lower in UIP than in fibrotic NSIP (p = 0.001) but not in patients with severe functional impairment; mortality during the first 2 years was linked solely to the severity of functional impairment at presentation. The composite physiologic index was the strongest determinant of outcome (p < 0.001). At 6 months, serial diffusing capacity levels (p = 0.003) and histopathologic diagnosis (p = 0.002) were prognostically equivalent. At 12 months, serial pulmonary function trends were the only major prognostic determinant (p < 0.0005 for all variables), with no independent significance associated with the distinction between UIP and fibrotic NSIP. We conclude that at 12 months, serial pulmonary function trends have considerable prognostic value in UIP and NSIP. Their histologic distinction provides no additional prognostic information when pulmonary function trends are clear cut or when functional impairment is severe.

Authors+Show Affiliations

Interstitial Lung Disease Unit, Emmanuel Kaye Building, Manresa Road, Chelsea, London SW6 LR6, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

12791580

Citation

Latsi, Panagiota I., et al. "Fibrotic Idiopathic Interstitial Pneumonia: the Prognostic Value of Longitudinal Functional Trends." American Journal of Respiratory and Critical Care Medicine, vol. 168, no. 5, 2003, pp. 531-7.
Latsi PI, du Bois RM, Nicholson AG, et al. Fibrotic idiopathic interstitial pneumonia: the prognostic value of longitudinal functional trends. Am J Respir Crit Care Med. 2003;168(5):531-7.
Latsi, P. I., du Bois, R. M., Nicholson, A. G., Colby, T. V., Bisirtzoglou, D., Nikolakopoulou, A., Veeraraghavan, S., Hansell, D. M., & Wells, A. U. (2003). Fibrotic idiopathic interstitial pneumonia: the prognostic value of longitudinal functional trends. American Journal of Respiratory and Critical Care Medicine, 168(5), 531-7.
Latsi PI, et al. Fibrotic Idiopathic Interstitial Pneumonia: the Prognostic Value of Longitudinal Functional Trends. Am J Respir Crit Care Med. 2003 Sep 1;168(5):531-7. PubMed PMID: 12791580.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fibrotic idiopathic interstitial pneumonia: the prognostic value of longitudinal functional trends. AU - Latsi,Panagiota I, AU - du Bois,Roland M, AU - Nicholson,Andrew G, AU - Colby,Thomas V, AU - Bisirtzoglou,Danai, AU - Nikolakopoulou,Ageliki, AU - Veeraraghavan,Srihari, AU - Hansell,David M, AU - Wells,Athol U, Y1 - 2003/06/05/ PY - 2003/6/7/pubmed PY - 2003/12/13/medline PY - 2003/6/7/entrez SP - 531 EP - 7 JF - American journal of respiratory and critical care medicine JO - Am J Respir Crit Care Med VL - 168 IS - 5 N2 - Survival is linked to the histopathologic distinction between usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP), the most commonly encountered fibrotic idiopathic interstitial pneumonia. We retrospectively compared the prognostic significance of histopathologic diagnoses, baseline pulmonary function indices, and serial trends in pulmonary function indices (diffusing capacity, FVC, FEV1, the recently defined composite physiologic index) at 6 and 12 months in 104 patients (UIP, n = 63; fibrotic NSIP, n = 41). Survival was lower in UIP than in fibrotic NSIP (p = 0.001) but not in patients with severe functional impairment; mortality during the first 2 years was linked solely to the severity of functional impairment at presentation. The composite physiologic index was the strongest determinant of outcome (p < 0.001). At 6 months, serial diffusing capacity levels (p = 0.003) and histopathologic diagnosis (p = 0.002) were prognostically equivalent. At 12 months, serial pulmonary function trends were the only major prognostic determinant (p < 0.0005 for all variables), with no independent significance associated with the distinction between UIP and fibrotic NSIP. We conclude that at 12 months, serial pulmonary function trends have considerable prognostic value in UIP and NSIP. Their histologic distinction provides no additional prognostic information when pulmonary function trends are clear cut or when functional impairment is severe. SN - 1073-449X UR - https://www.unboundmedicine.com/medline/citation/12791580/Fibrotic_idiopathic_interstitial_pneumonia:_the_prognostic_value_of_longitudinal_functional_trends_ L2 - https://www.atsjournals.org/doi/10.1164/rccm.200210-1245OC?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -