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Published ahead of print on May 28, 2003, doi:10.1164/rccm.200211-1311OC
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American Journal of Respiratory and Critical Care Medicine Vol 168. pp. 538-542, (2003)
© 2003 American Thoracic Society

Original Article

Changes in Clinical and Physiologic Variables Predict Survival in Idiopathic Pulmonary Fibrosis

Harold R. Collard, Talmadge E. King, Jr., Becki Bucher Bartelson, Jason S. Vourlekis, Marvin I. Schwarz and Kevin K. Brown

Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Health Sciences; National Jewish Medical and Research Center, Denver; Department of Biostatistics and Clinical Studies, NetRegulus, Centennial, Colorado; and Department of Medicine, San Francisco General Hospital, University of California at San Francisco, San Francisco, California

Correspondence and requests for reprints should be addressed to Kevin K. Brown, M.D., 1400 Jackson Street, Room F107, Denver, CO 80206. E-mail: brownk{at}njc.org

There is significant heterogeneity in survival time among patients with idiopathic pulmonary fibrosis. Studies of baseline clinical and physiologic variables as predictors of survival time have reported inconsistent results. We evaluated the predictive value of changes in clinical and physiologic variables over time for survival time in 81 patients with biopsy-proven idiopathic pulmonary fibrosis. Six-month changes in dyspnea score, total lung capacity, thoracic gas volume, FVC, FEV1, diffusing capacity of carbon monoxide, partial pressure of arterial oxygen, oxygen saturation, and alveolar–arterial oxygen gradient were predictive of survival time even after adjustment for baseline values. Analyses were repeated on 51 patients with 12-month change data. Twelve-month changes in dyspnea score, total lung capacity, FVC, partial pressure of arterial oxygen, oxygen saturation, and alveolar–arterial oxygen gradient were predictive of survival time after adjustment for baseline values. Evaluation of changes in clinical and physiological variables over 6 and 12 months may provide clinicians with more accurate prognostic information than baseline values alone.

Key Words: interstitial lung disease • pulmonary fibrosis • survival




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