Radiological usual interstitial pneumonia pattern is associated with two-year mortality in patients with idiopathic pulmonary fibrosis

Introduction: The new diagnostic guidelines for idiopathic pulmonary fibrosis (IPF) did not rule out the possibility of combining the radiological patterns of usual interstitial pneumonia (UIP) and probable UIP, given the similar management and diagnostic capacity. However, the prognostic implicatio...

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Autores: Gayá García-Manso, Ignacio, Arenas, Juan, Hernandez Blasco, Luis M., GARCIA GARRIGOS, ELENA, Nofuentes, Ester, Sirera, Marina, Ruiz-Alcaraz, Sandra, García Sevila, Raquel
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universidad Miguel Hernández de Elche
Repositorio:REDIUMH. Depósito Digital de la UMH
OAI Identifier:oai:dspace.umh.es:11000/38917
Acceso en línea:https://hdl.handle.net/11000/38917
Access Level:acceso abierto
Palabra clave:Idiopathic pulmonary fibrosis
Interstitial lung diseases
Radiological pattern
Usual interstitial pneumonia
Survival
CDU::6 - Ciencias aplicadas::61 - Medicina
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spelling Radiological usual interstitial pneumonia pattern is associated with two-year mortality in patients with idiopathic pulmonary fibrosisGayá García-Manso, IgnacioArenas, JuanHernandez Blasco, Luis M.GARCIA GARRIGOS, ELENANofuentes, EsterSirera, MarinaRuiz-Alcaraz, SandraGarcía Sevila, RaquelIdiopathic pulmonary fibrosisInterstitial lung diseasesRadiological patternUsual interstitial pneumoniaSurvivalCDU::6 - Ciencias aplicadas::61 - MedicinaIntroduction: The new diagnostic guidelines for idiopathic pulmonary fibrosis (IPF) did not rule out the possibility of combining the radiological patterns of usual interstitial pneumonia (UIP) and probable UIP, given the similar management and diagnostic capacity. However, the prognostic implications of these patterns have not been fully elucidated, with different studies showing heterogeneous results. We applied the new criteria to a retrospective series of patients with IPF, assessing survival based on radiological patterns, findings, and their extension. Methods: Two thoracic radiologists reviewed high-resolution computed tomography images taken at diagnosis in 146 patients with IPF, describing the radiological findings and patterns. The association of each radiological finding and radiological patterns with two-year mortality was analysed. Results: The two-year mortality rate was 40.2% in IPF patients with an UIP radiological pattern versus 7.1% in those with probable UIP. Compared to the UIP pattern, probable UIP was protective against mortality, even after adjusting for age, sex, pulmonary function, and extent of fibrosis (hazard ratio (HR) 0.23, 95% confidence interval (CI) 0.06-0.99). Receiving antifibrotic treatment was also a protective factor (HR 0.51, 95%CI 0.27-0.98). Honeycombing (HR 3.62, 95%CI 1.27-10.32), an acute exacerbation pattern (HR 4.07, 95%CI 1.84-8.96), and the overall extent of fibrosis (HR 1.04, 95%CI 1.02-1.06) were predictors of mortality. Conclusions: In our series, two-year mortality was higher in patients with IPF who presented a radiological pattern of UIP versus probable UIP on the initial scan. Honeycombing, an acute exacerbation pattern, and a greater overall extent of fibrosis were also predictors of increased mortality. The prognostic differences between the radiological pattern of UIP and probable UIP in our series would support maintaining them as two differentiated patterns.ElsevierDepartamentos de la UMH::Patología y CirugíaDepartamentos de la UMH::Medicina Clínica202620262024info:eu-repo/semantics/articleapplication/pdf11application/pdfhttps://hdl.handle.net/11000/38917reponame:REDIUMH. Depósito Digital de la UMHinstname:Universidad Miguel Hernández de ElcheIngléshttps://doi.org/10.1016/j.heliyon.2024.e26623info:eu-repo/semantics/openAccessAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/oai:dspace.umh.es:11000/389172026-05-27T13:36:21Z
dc.title.none.fl_str_mv Radiological usual interstitial pneumonia pattern is associated with two-year mortality in patients with idiopathic pulmonary fibrosis
title Radiological usual interstitial pneumonia pattern is associated with two-year mortality in patients with idiopathic pulmonary fibrosis
spellingShingle Radiological usual interstitial pneumonia pattern is associated with two-year mortality in patients with idiopathic pulmonary fibrosis
Gayá García-Manso, Ignacio
Idiopathic pulmonary fibrosis
Interstitial lung diseases
Radiological pattern
Usual interstitial pneumonia
Survival
CDU::6 - Ciencias aplicadas::61 - Medicina
title_short Radiological usual interstitial pneumonia pattern is associated with two-year mortality in patients with idiopathic pulmonary fibrosis
title_full Radiological usual interstitial pneumonia pattern is associated with two-year mortality in patients with idiopathic pulmonary fibrosis
title_fullStr Radiological usual interstitial pneumonia pattern is associated with two-year mortality in patients with idiopathic pulmonary fibrosis
title_full_unstemmed Radiological usual interstitial pneumonia pattern is associated with two-year mortality in patients with idiopathic pulmonary fibrosis
title_sort Radiological usual interstitial pneumonia pattern is associated with two-year mortality in patients with idiopathic pulmonary fibrosis
dc.creator.none.fl_str_mv Gayá García-Manso, Ignacio
Arenas, Juan
Hernandez Blasco, Luis M.
GARCIA GARRIGOS, ELENA
Nofuentes, Ester
Sirera, Marina
Ruiz-Alcaraz, Sandra
García Sevila, Raquel
author Gayá García-Manso, Ignacio
author_facet Gayá García-Manso, Ignacio
Arenas, Juan
Hernandez Blasco, Luis M.
GARCIA GARRIGOS, ELENA
Nofuentes, Ester
Sirera, Marina
Ruiz-Alcaraz, Sandra
García Sevila, Raquel
author_role author
author2 Arenas, Juan
Hernandez Blasco, Luis M.
GARCIA GARRIGOS, ELENA
Nofuentes, Ester
Sirera, Marina
Ruiz-Alcaraz, Sandra
García Sevila, Raquel
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Departamentos de la UMH::Patología y Cirugía
Departamentos de la UMH::Medicina Clínica
dc.subject.none.fl_str_mv Idiopathic pulmonary fibrosis
Interstitial lung diseases
Radiological pattern
Usual interstitial pneumonia
Survival
CDU::6 - Ciencias aplicadas::61 - Medicina
topic Idiopathic pulmonary fibrosis
Interstitial lung diseases
Radiological pattern
Usual interstitial pneumonia
Survival
CDU::6 - Ciencias aplicadas::61 - Medicina
description Introduction: The new diagnostic guidelines for idiopathic pulmonary fibrosis (IPF) did not rule out the possibility of combining the radiological patterns of usual interstitial pneumonia (UIP) and probable UIP, given the similar management and diagnostic capacity. However, the prognostic implications of these patterns have not been fully elucidated, with different studies showing heterogeneous results. We applied the new criteria to a retrospective series of patients with IPF, assessing survival based on radiological patterns, findings, and their extension. Methods: Two thoracic radiologists reviewed high-resolution computed tomography images taken at diagnosis in 146 patients with IPF, describing the radiological findings and patterns. The association of each radiological finding and radiological patterns with two-year mortality was analysed. Results: The two-year mortality rate was 40.2% in IPF patients with an UIP radiological pattern versus 7.1% in those with probable UIP. Compared to the UIP pattern, probable UIP was protective against mortality, even after adjusting for age, sex, pulmonary function, and extent of fibrosis (hazard ratio (HR) 0.23, 95% confidence interval (CI) 0.06-0.99). Receiving antifibrotic treatment was also a protective factor (HR 0.51, 95%CI 0.27-0.98). Honeycombing (HR 3.62, 95%CI 1.27-10.32), an acute exacerbation pattern (HR 4.07, 95%CI 1.84-8.96), and the overall extent of fibrosis (HR 1.04, 95%CI 1.02-1.06) were predictors of mortality. Conclusions: In our series, two-year mortality was higher in patients with IPF who presented a radiological pattern of UIP versus probable UIP on the initial scan. Honeycombing, an acute exacerbation pattern, and a greater overall extent of fibrosis were also predictors of increased mortality. The prognostic differences between the radiological pattern of UIP and probable UIP in our series would support maintaining them as two differentiated patterns.
publishDate 2024
dc.date.none.fl_str_mv 2024
2026
2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/11000/38917
url https://hdl.handle.net/11000/38917
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv https://doi.org/10.1016/j.heliyon.2024.e26623
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
rights_invalid_str_mv Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.format.none.fl_str_mv application/pdf
11
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:REDIUMH. Depósito Digital de la UMH
instname:Universidad Miguel Hernández de Elche
instname_str Universidad Miguel Hernández de Elche
reponame_str REDIUMH. Depósito Digital de la UMH
collection REDIUMH. Depósito Digital de la UMH
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,81155

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