Certain findings in a patient with idiopathic pulmonary fibrosis may indicate a longer survival vs disease progression.
Longer Survival (Favorable Factors)
Progressive Disease (Unfavorable Factors)
< 50 years
<= 1 year
preserved with mild dyspnea
history of current cigarette smoking at time of diagnosis
high resolution CT scan
ground glass and reticular opacities present
BAL fluid findings
increased lymphocytes (> 20%)
neutrophils > 5% or eosinophils > 5%
response to corticosteroid therapy at 3-6 months
beneficial response or stable disease
need for immuno-suppressive therapy
• 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.
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