Predictors of mortality in patients with interstitial lung disease treated with corticosteroids: results from a cohort study.

Abstract

Interstitial lung disease (ILD) has a heterogeneous clinical presentation and establishing prognosis for these patients is challenging. We investigated the clinical characteristics and outcome of patients with idiopathic interstitial pneumonias (IIPs) and patients with connective tissue disease-associated interstitial lung disease (CTD-ILD). We conducted a multicenter prospective study on 104 patients diagnosed with IIPs and 29 patients diagnosed with CTD-ILD, which were newly diagnosed and treated with corticosteroids initially. We compared the clinical characteristics, high-resolution computed tomography (HRCT) imaging date, and outcomes. Cox proportional hazard regression analysis was used to identify variables with increased risk of death. Survival was analyzed according to the Kaplan-Meier method and was assessed with the log-rank test. Of 133 patients with IIPs (n = 104) or CTD-ILD (n = 29), 44 patients died during the follow-up period (mean: 1.6 ± 0.78 years). Patients with IIPs seemed to be associated with worse survival compared with those with CTD-ILD; however, this difference was not significant (log-rank test, P = 0.084). Significant predictors for mortality in patients with IIPs at baseline were lower for performance status and definite usual interstitial pattern (UIP) on HRCT. Patients with UIP experienced worse survival than those with non-UIP. A definite UIP on HRCT and lower baseline performance status have important prognostic implications in patients with IIPs.

• Authors: Kiyoshi Migita, Toru Arai, Yuka Jiuchi, Yasumori Izumi, Nozomi Iwanaga, Chieko Kawahara, Eiichi Suematsu, Tomoya Miyamura, Hiroshi Tsutani, Yojiro Kawabe, Ryutaro Matsumura, Shunsuke Mori, Shiro Ohshima, Shigeru Yoshizawa, Yasuo Suenaga, Fumitaka Ogushi, Masaharu Kawabata, Hiroshi Furukawa, Toshihiro Matsui, Seiji Bito, Shigeto Tohma
• Journal: Medicine (Medicine (Baltimore)) Vol. 93 Issue 26 Pg. e175 (Nov 2014) ISSN: 1536-5964 [Electronic] United States
• PMID: 25474431 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Glucocorticoids

Topics

• Aged
• Cohort Studies
• Connective Tissue Diseases (complications, diagnosis, mortality)
• Drug Administration Schedule
• Female
• Glucocorticoids (therapeutic use)
• Humans
• Lung Diseases, Interstitial (drug therapy, etiology, mortality)
• Male
• Middle Aged
• Outcome Assessment, Health Care
• Prognosis
• Risk Factors
• Survival Analysis