Stubbe Beate, Ittermann Till, Grieger Anita, Walther Charlotte, Gläser Sven, Ewert Ralf
Internal Medicine B, Pulmonary Medicine, University Medicine Greifswald, Ferdinand-Sauerbruchstrasse, 17475 Greifswald, Germany.
Institute for Community Medicine, SHIP, University Medicine Greifswald, 17475 Greifswald, Germany.
J Clin Med. 2022 Mar 14;11(6):1609. doi: 10.3390/jcm11061609.
Interstitial lung disease (ILD) is associated with high rates of comorbidities and non-infectious lung disease mortality. Against this background, we aimed to evaluate the prognostic capacity of lung function and cardiopulmonary exercise testing (CPET) in patients with ILD.
A total of 183 patients with diverse ILD entities were included in this monocentric analysis. Prediction models were determined using Cox regression models with age, sex, body mass index (BMI), and all parameters from pulmonary function testing and CPET. Kaplan-Meier curves were plotted for selected variables.
The median follow-up period was 3.0 ± 2.5 years. Arterial hypertension (57%) and pulmonary hypertension (38%) were the leading comorbidities. The Charlson comorbidity index score was 2 ± 2 points. The 3-year and 5-year survival rates were 68% and 50%, respectively. VOpeak (mL/kg/min or %pred.) was identified as a significant prognostic parameter in patients with ILD. The cut-off value for discriminating mortality was 61%.
The present analyses consistently revealed the high prognostic power of VOpeak %pred. and other parameters evaluating breathing efficacy (VÉ/VCO @AT und VÉ/VCO slope) in ILD patients. VOpeak %pred., in contrast to the established prognostic values FVC %pred., DLCO/KCO %pred., and GAP, showed an even higher prognostic ability in all statistical models.
间质性肺疾病（ILD）与高合并症发生率和非感染性肺部疾病死亡率相关。在此背景下，我们旨在评估ILD患者肺功能和心肺运动试验（CPET）的预后能力。
本单中心分析纳入了183例患有不同ILD类型的患者。使用Cox回归模型确定预测模型，纳入年龄、性别、体重指数（BMI）以及肺功能测试和CPET的所有参数。针对选定变量绘制Kaplan-Meier曲线。
中位随访期为3.0±2.5年。动脉高血压（57%）和肺动脉高压（38%）是主要合并症。Charlson合并症指数评分为2±2分。3年和5年生存率分别为68%和50%。VOpeak（毫升/千克/分钟或预测值百分比）被确定为ILD患者的一个重要预后参数。区分死亡率的临界值为61%。
本分析一致显示VOpeak预测值百分比以及其他评估呼吸效率的参数（通气当量/二氧化碳排出当量@无氧阈和通气当量/二氧化碳排出当量斜率）在ILD患者中具有较高的预后价值。与既定的预后值FVC预测值百分比、DLCO/KCO预测值百分比和GAP相比，VOpeak预测值百分比在所有统计模型中显示出更高的预后能力。
