Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Respirology. 2018 Feb;23(2):206-212. doi: 10.1111/resp.13184. Epub 2017 Oct 12.
The Glasgow prognostic score (GPS) reflects the host systemic inflammatory response and is a validated independent prognostic factor in lung cancer. We investigated GPS as a potential predictive factor of clinical outcomes in idiopathic pulmonary fibrosis (IPF) patients with acute exacerbation (AE).
This was a retrospective study performed between January 2006 and March 2016 in Bucheon St. Mary's Hospital, The Catholic University of Korea. Overall, 327 admitted IPF patients were registered in the study. Patients with definite pneumonia at the time of admission, those with left-sided heart failure, pulmonary embolism and an identifiable cause of acute lung injury, and those whose albumin or C-reactive protein levels were not measured were excluded.
A total of 66 patients hospitalized with IPF-AE were finally included. Median survival was 20.7 days and 29 (43.9%) patients died during hospitalization. The median length of overall survival (OS) was 26.0, 20.0 and 15.0 days for GPS-0, GPS-1 and GPS-2, respectively. There were significant differences in OS between GPS-0 and GPS-2 (P = 0.002). In a multivariate analysis performed using a Cox regression model, eosinopenia (P = 0.007), lower partial pressure of oxygen/fraction of inspired oxygen ratio (P = 0.014), and higher GPS (P = 0.006) were independent predictors of mortality.
GPS can be helpful in predicting mortality in IPF patients with AE.
格拉斯哥预后评分（GPS）反映了宿主的全身炎症反应，是肺癌的一个经过验证的独立预后因素。我们研究了 GPS 作为特发性肺纤维化（IPF）急性加重（AE）患者临床结局的潜在预测因素。
这是一项在韩国天主教大学布川圣玛丽医院于 2006 年 1 月至 2016 年 3 月间进行的回顾性研究。总共登记了 327 名住院的 IPF 患者。排除入院时明确肺炎、左侧心力衰竭、肺栓塞和可识别的急性肺损伤原因以及白蛋白或 C 反应蛋白水平未测量的患者。
最终纳入了 66 例住院的 IPF-AE 患者。中位生存时间为 20.7 天，29 例（43.9%）患者在住院期间死亡。GPS-0、GPS-1 和 GPS-2 的中位总生存期（OS）分别为 26.0、20.0 和 15.0 天。GPS-0 和 GPS-2 之间的 OS 有显著差异（P=0.002）。使用 Cox 回归模型进行的多变量分析显示，嗜酸性粒细胞减少（P=0.007）、较低的氧分压/吸入氧分数比值（P=0.014）和较高的 GPS（P=0.006）是死亡率的独立预测因素。
GPS 有助于预测 IPF-AE 患者的死亡率。
