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Significance of lung shrinkage on CXR as a prognostic factor in patients with idiopathic pulmonary fibrosis
Author(s) -
KAWABATA Hidenobu,
NAGAI Sonoko,
HAYASHI Michio,
NAKAMURA Hiroshi,
NAGAO Taisi,
SHIGEMATSU Michio,
KITAICHI Masanori,
IZUMI Takateru
Publication year - 2003
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1046/j.1440-1843.2003.00469.x
Subject(s) - medicine , idiopathic pulmonary fibrosis , lung , usual interstitial pneumonia , proportional hazards model , hazard ratio , pulmonary fibrosis , lung biopsy , survival analysis , pulmonary function testing , gastroenterology , confidence interval
Objective: The aim of this study was to determine whether the presence of lung shrinkage on CXR can predict diminished survival in patients with idiopathic pulmonary fibrosis (IPF)/usual interstitial pneumonia (UIP). Methodology: In a hospital‐based cohort study 68 subjects diagnosed with IPF/UIP by surgical lung biopsy or at autopsy were observed for a mean of 7.6 years. The radiographic scores from Cherniack's method, pulmonary function tests, arterial blood gas, and haematological data were obtained at initial presentation. Longitudinal radiographic changes over a mean interval of 2.7 years were measured. Survival analysis was performed using Kaplan‐Meier and Cox's proportional hazards regression analysis. Results: At some point during the observation period 36 (53%) of 68 patients did not exhibit lung shrinkage and 32 (47%) of 68 patients showed lung shrinkage. Patients with lung shrinkage were more likely to have a diminished survival than those with lung preservation; median survival was 4.4 vs 7.8 years, respectively. Lung shrinkage during the observation period (hazard ratio, 3.89; 95% CI = 1.68–9.01; P = 0.001) was associated with lower rates of survival. Conclusion: In patients with IPF/UIP, lung shrinkage on CXR during the observation period was a poor prognostic factor.