Chest
Clinical Investigations; Articles; Interstitial Lung DiseaseChanges in Pulmonary Function Test Results After 1 Year of Therapy as Predictors of Survival in Patients With Idiopathic Pulmonary Fibrosis
Section snippets
Study Population
All patients 18 years of age or greater seen at Virginia Mason Medical Center (VMMC), Seattle, between 1970 and 1991 with a diagnosis of pulmonary fibrosis by diagnostic computer ICD-9 code and/or pathology report were reviewed. A diagnosis of IPF was established if the following three criteria were met: (1) the chest radiograph showed a diffuse reticulonodular infiltrate; (2) a lung biopsy (either open or transbronchial) specimen demonstrated interstitial fibrosis in the absence of granuloma,
Results
The records of 905 patients with ICD-9 code and/or pathology reports of “pulmonary fibrosis” were reviewed. Five hundred three patients had focal radiographic change rather than diffuse parenchymal disease. Two hundred forty-two patients with diffuse pulmonary fibrosis had identifiable causes of the pulmonary scarring, including 102 patients with collagen vascular disease, 52 patients with postinfectious pulmonary fibrosis, 30 patients with sarcoidosis, 20 patients with postirradiation change,
Discussion
Previous clinical studies have emphasized pretreatment variables that are predictive of a beneficial response to treatment. A duration of disease of less than 1 year, more cellular reaction with less fibrosis on open lung biopsy specimen, and a bronchoalveolar lavage cell population with increased proportions of lymphocytes have each been correlated with better response to treatment.6, 7, 8, 9, 10, 11
This study was conducted to assess the ability of changes in pulmonary function testing at 1
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