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Acute exacerbation of idiopathic pulmonary fibrosis: high-resolution CT scores predict mortality.
MedLine Citation:
PMID:  21822949     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To determine high-resolution computed tomography (HRCT) findings helpful in predicting mortality in patients with acute exacerbation of idiopathic pulmonary fibrosis (AEx-IPF). METHODS: Sixty patients with diagnosis of AEx-IPF were reviewed retrospectively. Two groups (two observers each) independently evaluated pattern, distribution, and extent of HRCT findings at presentation and calculated an HRCT score at AEx based on normal attenuation areas and extent of abnormalities, such as areas of ground-glass attenuation and/or consolidation with or without traction bronchiectasis or bronchiolectasis and areas of honeycombing. The correlation between the clinical data including the HRCT score and mortality (cause-specific survival) was evaluated using the univariate and multivariate Cox-regression analyses. RESULTS: Serum KL-6 level, PaCO(2), and the HRCT score were statistically significant predictors on univariate analysis. Multivariate analysis revealed that the HRCT score was an independently significant predictor of outcome (hazard ratio, 1.13; 95% confidence interval, 1.06-1.19, P = 0.0002). The area under receiver operating characteristics curve for the HRCT score was statistically significant in the classification of survivors or nonsurvivors (0.944; P < 0.0001). Survival in patients with HRCT score ≥245 was worse than those with lower score (log-rank test, P < 0.0001). CONCLUSION: The HRCT score at AEx is independently related to prognosis in patients with AEx-IPF. Key Points •High-Resolution Computed Tomography (HRCT) helps clinicians to assess patients with interstitial fibrosis. •The main abnormalities of acute exacerbation are ground-glass opacification and consolidation. •Extent of abnormalities on HRCT correlates with poor prognosis.
Authors:
Kiminori Fujimoto; Hiroyuki Taniguchi; Takeshi Johkoh; Yasuhiro Kondoh; Kazuya Ichikado; Hiromitsu Sumikawa; Takashi Ogura; Kensuke Kataoka; Takahiro Endo; Atsushi Kawaguchi; Nestor L Müller
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-7
Journal Detail:
Title:  European radiology     Volume:  -     ISSN:  1432-1084     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Radiology, Kurume University School of Medicine, and Center for Diagnostic Imaging, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan, kimichan@med.kurume-u.ac.jp.
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