Certain findings in a patient with idiopathic pulmonary fibrosis may indicate a longer survival vs disease progression.
|
Parameter |
Longer Survival (Favorable Factors) |
Progressive Disease (Unfavorable Factors) |
|
age |
< 50 years |
|
|
gender |
female |
|
|
symptomatic period |
<= 1 year |
|
|
pulmonary function |
preserved with mild dyspnea |
severe dyspnea |
|
history of current cigarette smoking at time of diagnosis |
present |
|
|
high resolution CT scan |
ground glass and reticular opacities present |
extensive fibrosis |
|
BAL fluid findings |
increased lymphocytes (> 20%) |
neutrophils > 5% or eosinophils > 5% |
|
response to corticosteroid therapy at 3-6 months |
beneficial response or stable disease |
progressive disease |
|
need for immuno-suppressive therapy |
none |
yes |
where:
• I wonder if the short symptomatic period indicating longer survival is a form of bias.
• The need for immunosuppression and the severity of dyspnea are proxy measures for disease severity.
Specialty: Pulmonology
ICD-10: ,
