Risk factors for progression of pulmonary fibrosis: a single-centered, retrospective study.

Autor:	Fan JJ; Department of Pulmonary Disease, Sunsimiao Hospital, Shanxi, China., Gu JM; Institute of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China.; National Center for Respiratory Medicine, Beijing, China.; State Key Laboratory of Respiratory Health and Multimorbidity, Beijing, China.; National Clinical Research Center for Respiratory Diseases, Beijing, China.; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.; Department of Traditional Chinese Medicine for Pulmonary Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China., Xiao SY; National Center for Respiratory Medicine, Beijing, China.; State Key Laboratory of Respiratory Health and Multimorbidity, Beijing, China.; National Clinical Research Center for Respiratory Diseases, Beijing, China.; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.; Department of Traditional Chinese Medicine for Pulmonary Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China., Jia MY; National Center for Respiratory Medicine, Beijing, China.; State Key Laboratory of Respiratory Health and Multimorbidity, Beijing, China.; National Clinical Research Center for Respiratory Diseases, Beijing, China.; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.; Department of Traditional Chinese Medicine for Pulmonary Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China., Han GL; National Center for Respiratory Medicine, Beijing, China.; State Key Laboratory of Respiratory Health and Multimorbidity, Beijing, China.; National Clinical Research Center for Respiratory Diseases, Beijing, China.; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.; Department of Traditional Chinese Medicine for Pulmonary Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.
Jazyk:	angličtina
Zdroj:	Frontiers in medicine [Front Med (Lausanne)] 2024 Feb 07; Vol. 11, pp. 1335758. Date of Electronic Publication: 2024 Feb 07 (Print Publication: 2024).
DOI:	10.3389/fmed.2024.1335758
Abstrakt:	Objective: This study aimed to identify clinical characteristics associated with the prevalence of progressive pulmonary fibrosis (PPF) in interstitial lung disease (ILD) and to develop a prognostic nomogram model for clinical use. Methods: In this single-centered, retrospective study, we enrolled ILD patients with relatively comprehensive clinical data and assessed the incidence of PPF within a year using collected demographics, laboratory data, high-resolution computed tomography (HRCT), and pulmonary function test (PFT) results. We used a training cohort of ILD patients to identify early predictors of PPF and then validated them in an internal validation cohort and subsets of ILD patients using a multivariable logistic regression analysis. A prognostic nomogram was formulated based on these predictors, and the accuracy and efficiency were evaluated using the area under the receiver operating characteristic curve (AUC), calibration plot, and decision curve analysis (DCA). Results: Among the enrolled patients, 120 (39.09%) cases had connective tissue disease-associated interstitial lung disease (CTD-ILD), 115 (37.46%) had non-idiopathic pulmonary fibrosis idiopathic interstitial pneumonia (non-IPF IIP), and 35 (11.4%) had hypersensitivity pneumonitis (HP). Overall, 118 (38.4%) cases experienced pulmonary fibrosis progression. We found that baseline DLco% pred (OR 0.92; 95% CI, 8.93-0.95) was a protective factor for ILD progression, whereas combined pneumonia (OR 4.57; 95% CI, 1.24-18.43), modified Medical Research Council dyspnea score (mMRC) (OR 4.9; 95% CI, 2.8-9.5), and high-resolution computed tomography (HRCT) score (OR 1.22; 95% CI, 1.07-1.42) were independent risk factors for PPF. The AUC of the proposed nomogram in the development cohort was 0.96 (95% CI, 0.94, 0.98), and the calibration plot showed good agreement between the predicted and observed incidence of PPF (Hosmer-Lemeshow test: P = 0.86). Conclusion: ILD patients with combined pneumonia, low baseline DLco% pred, high mMRC marks, and high HRCT scores were at higher risk of progression. This nomogram demonstrated good discrimination and calibration, indicating its potential utility for clinical practice. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Fan, Gu, Xiao, Jia and Han.)
Databáze:	MEDLINE
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