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ILD-GAP 联合 Charlson 共病指数评分(ILD-GAPC)作为间质性肺疾病患者的预后预测模型。

ILD-GAP Combined with the Charlson Comorbidity Index Score (ILD-GAPC) as a Prognostic Prediction Model in Patients with Interstitial Lung Disease.

机构信息

Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.

Department of Biostatistics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.

出版信息

Can Respir J. 2023 Feb 8;2023:5088207. doi: 10.1155/2023/5088207. eCollection 2023.

Abstract

BACKGROUND

The ILD-GAP scoring system has been widely used to predict the prognosis of patients with interstitial lung disease (ILD). The ability of the ILD-GAP scoring system combined with the Charlson Comorbidity Index score (CCIS) (ILD-GAPC) to predict ILD prognosis was investigated.

METHODS

In ILD patients, including idiopathic pulmonary fibrosis (IPF), idiopathic nonspecific interstitial pneumonia (iNSIP), collagen vascular disease-related interstitial pneumonia (CVD-IP), chronic hypersensitivity pneumonitis (CHP), and unclassifiable ILD (UC-ILD), treated between April 2013 and April 2017, the relationships between baseline clinical parameters, including age, sex, CCIS, ILD diagnosis, pulmonary function test results, and disease outcomes, were retrospectively assessed, and the ability to predict prognosis was compared between the ILD-GAP and ILD-GAPC models, respectively.

RESULTS

A total of 185 patients (mean age, 71.9 years), all of whom underwent pulmonary function testing, including percentage predicted diffusion capacity for carbon monoxide, were assessed. ILD diagnosis consisted of IPF in 57 cases, iNSIP and CVD-IP in 117 cases, CHP in 6 cases, and UC-ILD in 5 cases. The ILD-GAPC provided a greater area under the receiver operating characteristic curve (0.758) for predicting 3-year ILD-related events than the ILD-GAP (0.721). In addition, log-rank tests showed that the Kaplan-Meier curves differed significantly among low, middle, and high ILD-GAPC scores ( < 0.001), unlike ILD-GAP scores ( = 0.083).

CONCLUSIONS

The ILD-GAPC model could provide more accurate information for predicting prognosis in patients with ILD than the ILD-GAP model.

摘要

背景

ILD-GAP 评分系统已被广泛用于预测间质性肺疾病(ILD)患者的预后。本研究旨在探讨 ILD-GAP 评分系统联合 Charlson 合并症指数评分(CCIS)(ILD-GAPC)预测ILD 预后的能力。

方法

回顾性分析 2013 年 4 月至 2017 年 4 月间收治的特发性肺纤维化(IPF)、特发性非特异性间质性肺炎(iNSIP)、结缔组织疾病相关性间质性肺炎(CVD-IP)、慢性过敏性肺炎(CHP)和未分类间质性肺病(UC-ILD)患者的临床基线参数(年龄、性别、CCIS、ILD 诊断、肺功能检查结果和疾病结局等)与预后的关系,并分别比较 ILD-GAP 和 ILD-GAPC 模型预测预后的能力。

结果

共纳入 185 例患者(平均年龄 71.9 岁),所有患者均行肺功能检查,包括一氧化碳弥散量占预计值的百分比。ILD 诊断包括 57 例 IPF、117 例 iNSIP 和 CVD-IP、6 例 CHP 和 5 例 UC-ILD。ILD-GAPC 预测 3 年ILD 相关事件的受试者工作特征曲线下面积(AUC)大于 ILD-GAP(分别为 0.758 和 0.721)。此外,log-rank 检验显示,ILD-GAPC 评分低、中、高分组的 Kaplan-Meier 曲线差异有统计学意义(<0.001),ILD-GAP 评分差异无统计学意义(=0.083)。

结论

ILD-GAPC 模型比 ILD-GAP 模型能为预测ILD 患者的预后提供更准确的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a618/9931459/590002fce283/CRJ2023-5088207.001.jpg

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