Comparisons of prognosis between surgically and clinically diagnosed idiopathic pulmonary fibrosis using gap model: A Korean national cohort study

Sang Hoon Lee, Song Yee Kim, Dong Soon Kim, Young Whan Kim, Man Pyo Chung, Soo Taek Uh, Choon Sik Park, Sung Hwan Jeong, Yong Bum Park, Hong Lyeol Lee, Jong Wook Shin, Eun Joo Lee, Jin Hwa Lee, Yangin Jegal, Hyun Kyung Lee, Yong Hyun Kim, Jin Woo Song, Moo Suk Park

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Abstract

Although a multidisciplinary approach has become an important criterion for an idiopathic pulmonary fibrosis (IPF) diagnosis, lung biopsies remain crucial. However, the prognosis of patients with surgically diagnosed IPF (sIPF) is uncertain. We aimed to investigate the prognosis of patients with clinically diagnosed IPF (cIPF) and sIPF. In this retrospective observational study, the Korean Interstitial Lung Disease Study Group conducted a national survey to evaluate the clinical, physiological, radiological, and survival characteristics of patients with IPF from January 1, 2003 to December 31, 2007. Patients were recruited from 54 universities and teaching hospitals across the Republic of Korea. IPF diagnoses were established according to the 2002 American Thoracic Society (ATS)/European Respiratory Society criteria (ERS) guideline. A total of 1685 patients with IPF (1027 cIPF and 658 sIPF) were enrolled. Patients with sIPF were significantly younger, predominantly female, and nonsmokers (all P<0.001). sIPF group had significantly better initial pulmonary function. The proportion of computed tomography- based honeycomb findings of patients with cIPF was higher than in those with sIPF (P<0.001). A Kaplan-Meier analysis showed that the sIPF group had a better prognosis (P=0.001). A survival analysis showed that age, pulmonary function parameters, pulmonary oxygen tension, honeycombing change, and combined lung cancer had a significant influence on patient prognosis. However, there was no significant difference in prognosis between the cIPF and sIPF groups after adjusting for GAP (gender, age, physiology) stage. The patients with sIPF had better clinical features than those with cIPF. However, after adjusting for GAP stage, the sIPF group showed similar prognoses as the cIPF group. This study showed that after adjusting for GAP stage, the prognosis of patients with IPF is the same regardless of the diagnostic method used.

Original languageEnglish
Article numbere3105
JournalMedicine (United States)
Volume95
Issue number11
DOIs
Publication statusPublished - 2016 Jan 1

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ASJC Scopus subject areas

  • Medicine(all)

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Lee, S. H., Kim, S. Y., Kim, D. S., Kim, Y. W., Chung, M. P., Uh, S. T., Park, C. S., Jeong, S. H., Park, Y. B., Lee, H. L., Shin, J. W., Lee, E. J., Lee, J. H., Jegal, Y., Lee, H. K., Kim, Y. H., Song, J. W., & Park, M. S. (2016). Comparisons of prognosis between surgically and clinically diagnosed idiopathic pulmonary fibrosis using gap model: A Korean national cohort study. Medicine (United States), 95(11), [e3105]. https://doi.org/10.1097/MD.0000000000003105