Abstract:
BACKGROUND:The clinical course of idiopathic pulmonary fibrosis (IPF) is characterized by progressive decline in lung function and eventual mortality. We sought to determine if future declines in pulmonary function, mortality, or both can be predicted from prior trends in pulmonary function tests (PFTs). METHODS:Data from 1981 to 2008 on 4,431 PFTs and mortality were analyzed from 734 subjects with IPF. The Kaplan-Meier method was used for mortality analyses. Mixed models were used to describe longitudinal pulmonary function dynamics, since PFTs were observed at varying time points from baseline. RESULTS:During the first year of follow-up, 135 subjects (73%) had stable FVC while 50 subjects (37%) showed a decline in FVC. During months 12 to 24 (1-2 years after diagnosis), a stable FVC occurred with the same frequency among both subjects whose FVC had declined during year 1 and whose FVC had remained stable (84.0% and 80.7%, respectively; P=.59). Among subjects alive at the end of year 1, those with a stable FVC were more likely to be alive at the end of year 2 than those whose FVC declined (hazard ratio [HR], 0.91 [95% CI, 0.87-0.94] and HR, 0.71 [95% CI, 0.62-0.78], respectively). CONCLUSIONS:PFT decline predicts early mortality, but not future declines in physiology, regardless of time since diagnosis.
journal_name
Chestjournal_title
Chestauthors
Schmidt SL,Tayob N,Han MK,Zappala C,Kervitsky D,Murray S,Wells AU,Brown KK,Martinez FJ,Flaherty KRdoi
10.1378/chest.13-0844subject
Has Abstractpub_date
2014-03-01 00:00:00pages
579-585issue
3eissn
0012-3692issn
1931-3543pii
S0012-3692(15)34371-3journal_volume
145pub_type
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