Factors Influence Mortality in Interstitial Lung Disease in Central Chest Institute of Thailand Analyzed by the 2018 ATS/ERS/JRS/ALAT HRCT Classification Criteria

Abstract

Background: Interstitial lung disease (ILD), has been recognized as a rare disease. Idiopathic interstitial pneumonia (IIP) is one group of ILD which classified after exclusion of specific causes. Among IIP, HRCT characteristics was mainly used for diagnosis recently classified by the 2018 ATS/ERS/JRS/ALAT as UIP, probable UIP, indeterminate UIP and alternative diagnosis. Idiopathic pulmonary fibrosis (IPF) which has radiological and histological terms as Usual interstitial pneumonia (UIP) is the most prevalent and associated with significant mortality in the world which have not much information in Thailand. Objective —We aimed to study whether UIP is the most prevalent and associated with significant mortality or not and examine factors that affect mortality related to the high-resolution computed tomography (HRCT) patterns in patients with ILD by using HRCT pattern classification according to the latest guideline on idiopathic pulmonary fibrosis [1]. Methods — We analyzed the medical records of 201 consecutive patients diagnosed as having ILD in ILD clinic at Central Chest Institute of Thailand. The HRCT classifications were defined as UIP, probable UIP, indeterminate UIP and alternative diagnosis. To detect differences between groups, Fisher’s exact test or Chi-square test was used as appropriate. Predictors of prognosis were determined using Cox regression models. Kaplan-Meier curves were generate and survival was compared among the four patterns using a log rank test for trend. Results — One hundred four patients (53%) had HRCT findings classified as UIP, 34 (18%) as probable UIP, 12 (6%) as indeterminate UIP and 45 (23%) as alternative diagnosis. Thirty-one patients (72%) with UIP were died out of total 43 deaths in this clinic. Multivariate analysis showed that male patients was negative prognostic factors of mortality whereas 6MWT distance was protective prognostic factors of mortality. Citation: Jun-Kroot., S. (2021) Factors Influence Mortality in Interstitial Lung Disease in Central Chest Institute of Thailand Analyzed by the 2018 ATS/ERS/JRS/ALAT HRCT Classification Criteria. J Pulm Med Respir Care, 3(1): 09-17. Journal of Pulmonary Medicine and Respiratory Care © 2021 Somato Publications. All rights reserved. Volume 3 Issue 1 - 1007 10 Conclusion —Our results emphasize the increased prevalent in UIP patients significantly but increased mortality insignificantly compared with other groups. The impact on patient survival provides evidence that development of better strategies for the management of ILD could significantly lower the excess mortality of ILD patients.