Idiopathic pulmonary fibrosis prognostic factors - analysis of the Czech registry

• Published in: Časopis lékařů českých Vol. 155; no. 4; p. 22
• Main Authors: Doubková, Martina, Uher, Michal, Bartoš, Vladimír, Šterclová, Martina, Lacina, Ladislav, Lošťáková, Vladimíra, Binková, Ilona, Plačková, Martina, Žurková, Monika, Bittenglová, Radka, Pšikalová, Jana, Šišková, Lenka, Lisá, Pavlína, Petřík, František, Polák, Jaroslav, Řihák, Vladimír, Skřičková, Jana, Vašáková, Martina
• Format: Journal Article
• Language: Czech
• Published: Czech Republic 2016
• Subjects: Age Factors; Aged; Czech Republic; Female; Humans; Idiopathic Pulmonary Fibrosis - diagnosis; Idiopathic Pulmonary Fibrosis - physiopathology; Male; Prognosis; Registries; Respiratory Function Tests - statistics & numerical data; Severity of Illness Index; Survival Rate
• ISSN: 0008-7335

Idiopathic pulmonary fibrosis (IPF) is a rare, progressive and usually fatal form of idiopathic interstitial pneumonia. IPF is characterized by failure of alveolar re-epithelization, persistence of fibroblasts, deposition of extracellular matrix, and distortion of lung architecture, which ultimately results in respiratory failure.We analysed 202 consecutive patients with IPF diagnosed at the Departments of Pulmonary Diseases and Tuberculosis in the Czech Republic, who they were included in the nationwide Czech IPF registry. Our aim was to determine prognostic factors of IPF and outcome of the disease.There were 129 males and 73 females who were the median age 67 years. IPF was biopsy-proven in 66 (33 %) of patients. Median time from the first symptom to diagnosis was 12 months. Diagnosis was made in 57 patients (28.3 %) within 6 months from the onset of respiratory symptoms. 8 (4 %) patients had an acute exacerbation during the course of the disease.In uniparametric (univariate) analysis as prognostic factors associated with poorer survival were found: higher age, higher degree dyspnea scores, clubbing fingers, comorbidities (arterial hypertension, osteoporosis), patients without histology biopsy, and bronchoalveolar increased neutrophil count. We found these positive prognostic factors: higher levels of VC (vital capacity), TLC (total lung capacity) and DLCO (diffusing capacity for carbon monooxide).In multiparametric (multivariate) analysis as prognostic factors associated with mortality were found: higher age, higher degree of dyspnoe score. Increased lymphocytes in bronchoalveolar fluid, higher level of VC a DLCO were associated with better survival. There was no difference in survival of patients by sex, by smoking status. No significant difference in survival rates was found between IPF with and without emphysema, between the extent of fibrosis on HRCT (high resolution computed tomography) of thorax and mortality. Median survival was 51.6 months. 58 (28.7 %) patients died. The most frequent reason of dead was IPF progression with respiratory failure.
Idiopathic pulmonary fibrosis; prognosis; treatment.