Abstract
Introduction: The expert multidisciplinary (MDT) approach is crucial for the accurate diagnosis of interstitial lung diseases (ILD), however the presence of this MDT is not always possible in centers with ILD management.
Objectives: To evaluate the relevance of each disciplinary approach (clinical, biochemical, radiological, histological) included in the MDT assessment of ILD patients.
Methods: Prospective observational study of all first visits evaluated in the ILD Unit during 2014. The assessment was determined by; A-1) detailed history, complete autoimmunity and precipitin, genetic study to family suspected, A-2) identifying radiological pattern of chest tomography (HRCT) by two independent radiologists, A-3) Pathology, A-4): MDT committee discussion (cases in which A1+/- A2 or A3 did not reach the diagnosis).
Results: From the included 158 cases (89 men, mean age 64.4 years), 77 patients were referred from primary care centers and local hospitals. The median time from the visit request to the diagnosis was 4.97 months (IQR 7.8). 91 had an initial diagnosis, which was modified in 18 cases: 3 by A-1, 1 by A-3, 5 by A-4, 9 by A-1+A-2. The final diagnosis was obtained in 149 cases. From the 9 patients with no diagnosis: 6 had advanced age and/or comorbidities, and 3 by low diagnostic yield of lung biopsy (incipient disease). A-4 was made in 23 cases (14.6%). 48 samples of lung pathology were analyzed (31 surgical biopsy and 17 cryobiopsy).
Conclusions: The MDT committee discussion is mandatory in almost one third of cases for the final diagnosis. An exhaustive clinical and serological study together with an expert radiological evaluation is the most effective requirement to manage ILD patients.
- Interstitial lung disease
- Idiopathic pulmonary fibrosis
- Interstitial lung disease (connective tissue disease)
- Copyright ©the authors 2016