Prognostic classification in acute exacerbation of idiopathic pulmonary fibrosis: a multicentre retrospective cohort study

Abstract Acute exacerbation (AE) in idiopathic pulmonary fibrosis (IPF) is a major prognostic determinant. However, evidence for its prognostic strength is mainly based on the results of small cohort studies with statistical limitations. This retrospective study, which included 108 patients with a f...

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Autores principales:	Takahito Suzuki, Hironao Hozumi, Koichi Miyashita, Masato Kono, Yuzo Suzuki, Masato Karayama, Kazuki Furuhashi, Hirotsugu Hasegawa, Tomoyuki Fujisawa, Noriyuki Enomoto, Yutaro Nakamura, Naoki Inui, Koshi Yokomura, Hidenori Nakamura, Takafumi Suda
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0e0643371bdb413c96c5184a22bb1dc7
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spelling	oai:doaj.org-article:0e0643371bdb413c96c5184a22bb1dc72021-12-02T13:40:50ZPrognostic classification in acute exacerbation of idiopathic pulmonary fibrosis: a multicentre retrospective cohort study10.1038/s41598-021-88718-22045-2322https://doaj.org/article/0e0643371bdb413c96c5184a22bb1dc72021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-88718-2https://doaj.org/toc/2045-2322Abstract Acute exacerbation (AE) in idiopathic pulmonary fibrosis (IPF) is a major prognostic determinant. However, evidence for its prognostic strength is mainly based on the results of small cohort studies with statistical limitations. This retrospective study, which included 108 patients with a first episode of AE-IPF, aimed to identify prognostic factors and to develop prognostic classification models. Multivariate Cox regression analysis revealed that a lower percent-predicted forced vital capacity within 12 months before AE onset (baseline %FVC) and a lower PaO2/FiO2 ratio at AE onset were independent mortality predictors. If the value of each predictor was lower than the cutoff determined by receiver-operating characteristic analysis, 1 point was assigned. Classification of patients into mild, moderate, and severe groups based on total score showed post-AE 90-day cumulative survival rates of 83.3%, 66.2%, and 22.2%, respectively (model 1: C-index 0.702). Moreover, a decision tree-based model was created with the recursive partitioning method using baseline %FVC and PaO2/FiO2 ratio at AE onset from among multivariable; accordingly, patients were classified into 3 groups with post-AE 90-day cumulative survival rates of 84.1%, 64.3%, and 24.0%, respectively (model 2: C-index 0.735). These models can guide clinicians in determining therapeutic strategies and help design future studies on AE-IPF.Takahito SuzukiHironao HozumiKoichi MiyashitaMasato KonoYuzo SuzukiMasato KarayamaKazuki FuruhashiHirotsugu HasegawaTomoyuki FujisawaNoriyuki EnomotoYutaro NakamuraNaoki InuiKoshi YokomuraHidenori NakamuraTakafumi SudaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Takahito Suzuki Hironao Hozumi Koichi Miyashita Masato Kono Yuzo Suzuki Masato Karayama Kazuki Furuhashi Hirotsugu Hasegawa Tomoyuki Fujisawa Noriyuki Enomoto Yutaro Nakamura Naoki Inui Koshi Yokomura Hidenori Nakamura Takafumi Suda Prognostic classification in acute exacerbation of idiopathic pulmonary fibrosis: a multicentre retrospective cohort study
description	Abstract Acute exacerbation (AE) in idiopathic pulmonary fibrosis (IPF) is a major prognostic determinant. However, evidence for its prognostic strength is mainly based on the results of small cohort studies with statistical limitations. This retrospective study, which included 108 patients with a first episode of AE-IPF, aimed to identify prognostic factors and to develop prognostic classification models. Multivariate Cox regression analysis revealed that a lower percent-predicted forced vital capacity within 12 months before AE onset (baseline %FVC) and a lower PaO2/FiO2 ratio at AE onset were independent mortality predictors. If the value of each predictor was lower than the cutoff determined by receiver-operating characteristic analysis, 1 point was assigned. Classification of patients into mild, moderate, and severe groups based on total score showed post-AE 90-day cumulative survival rates of 83.3%, 66.2%, and 22.2%, respectively (model 1: C-index 0.702). Moreover, a decision tree-based model was created with the recursive partitioning method using baseline %FVC and PaO2/FiO2 ratio at AE onset from among multivariable; accordingly, patients were classified into 3 groups with post-AE 90-day cumulative survival rates of 84.1%, 64.3%, and 24.0%, respectively (model 2: C-index 0.735). These models can guide clinicians in determining therapeutic strategies and help design future studies on AE-IPF.
format	article
author	Takahito Suzuki Hironao Hozumi Koichi Miyashita Masato Kono Yuzo Suzuki Masato Karayama Kazuki Furuhashi Hirotsugu Hasegawa Tomoyuki Fujisawa Noriyuki Enomoto Yutaro Nakamura Naoki Inui Koshi Yokomura Hidenori Nakamura Takafumi Suda
author_facet	Takahito Suzuki Hironao Hozumi Koichi Miyashita Masato Kono Yuzo Suzuki Masato Karayama Kazuki Furuhashi Hirotsugu Hasegawa Tomoyuki Fujisawa Noriyuki Enomoto Yutaro Nakamura Naoki Inui Koshi Yokomura Hidenori Nakamura Takafumi Suda
author_sort	Takahito Suzuki
title	Prognostic classification in acute exacerbation of idiopathic pulmonary fibrosis: a multicentre retrospective cohort study
title_short	Prognostic classification in acute exacerbation of idiopathic pulmonary fibrosis: a multicentre retrospective cohort study
title_full	Prognostic classification in acute exacerbation of idiopathic pulmonary fibrosis: a multicentre retrospective cohort study
title_fullStr	Prognostic classification in acute exacerbation of idiopathic pulmonary fibrosis: a multicentre retrospective cohort study
title_full_unstemmed	Prognostic classification in acute exacerbation of idiopathic pulmonary fibrosis: a multicentre retrospective cohort study
title_sort	prognostic classification in acute exacerbation of idiopathic pulmonary fibrosis: a multicentre retrospective cohort study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/0e0643371bdb413c96c5184a22bb1dc7
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_version_	1718392597364342784

Prognostic classification in acute exacerbation of idiopathic pulmonary fibrosis: a multicentre retrospective cohort study

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