Walsh et al developed a 2-stage classification system for pulmonary sarcoidosis. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in England, Italy and Greece.
Patient selection: pulmonary sarcoidosis
Outcome: mortality
Parameters:
(1) composite physiologic index (CPI) for idiopathic pulmonary fibrosis
(2) percent pulmonary fibrosis in high-resolution CT (HRCT)
(3) ratio of main pulmonary artery diameter to ascending aorta diameter
Parameter
Finding
Points
CPI
<= 40
0
> 40
1
percent pulmonary fibrosis
<= 20%
0
> 20%
1
ratio main PA to aorta ratio
<= 1
0
> 1
1
score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
• A score >= 1 is associated with the high risk group and a poor prognosis.
Stage
5-Year Mortality
good
11-19%
bad
47-53%
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