Prognostic significance of Glasgow prognostic score in patients with acute exacerbation of idiopathic pulmonary fibrosis

Kang, Hye Seon; Cho, Kang W.; Kwon, Soon Suk; Kim, Yong Hyun

doi:10.1111/resp.13184

Cited by 28 publications

(18 citation statements)

References 45 publications

(85 reference statements)

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“…A total of five studies reported PaO 2 /FiO 2 ratio using multivariate analysis. PaO 2 /FiO 2 ratio was demonstrated to be significantly associated with all-cause mortality in four studies with ORs of 0.99 (95% CI 0.98 to 1.00) 47 and 0.99 (95% CI 0.99 to 1.00) 59 and HRs of 0.99 (95% CI 0.99 to 1.00) 51 and 0.31 (95% CI 0.14 to 0.67) 64 , respectively. In another Open access Figure 2 Forest plot of the result of univariate analysis for partial pressure of arterial oxygen/fraction of inspired oxygen (PaO 2 / FiO 2 ) ratio (combined by HR).…”

Section: Discussionmentioning

confidence: 96%

Systematic review and meta-analysis of prognostic factors of acute exacerbation of idiopathic pulmonary fibrosis

Kamiya

Panlaqui

2020

BMJ Open

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ObjectiveTo clarify prognostic factors of acute exacerbation (AE) of idiopathic pulmonary fibrosis (IPF).DesignA systematic review and meta-analysis.Data sourcesMedline, Embase and Science Citation Index Expanded were searched from 2002 through 1 March 2019.Eligibility criteria for selecting studiesThe review included primary studies addressing the association between the outcomes such as all-cause mortality of AE of IPF and its potential prognostic factors, which were designated as any clinical information related to the outcomes.Data extraction and synthesisTwo reviewers extracted relevant data independently and assessed risk of bias. Univariate results were pooled using a random-effect model if at least three studies were available. Prognostic factors were determined based on significant and consistent results on both univariate and multivariate analyses in the majority of studies.ResultsOut of a total of 6763 articles retrieved, 37 were eligible and 31 potential prognostic factors for all-cause mortality were selected. Each study was subject to certain methodological shortcomings. The following five factors were statistically significant by a meta-analysis of univariate results, which was confirmed by multivariate analysis, that is, Acute Physiology and Chronic Health Evaluation (APACHE) II score (HR 1.10, 1.01 to 1.19), partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) ratio (ORs 0.99 in two studies and HRs 0.31 and 0.99 in two studies, respectively), lactate dehydrogenase (LDH) (HRs 1.002, 1.003, 1.01 and 1.02), white blood cell (WBC) count (OR 1.38, 1.04 to 1.83) and oxygen therapy before AE (HRs 3.68, 1.05 to 12.9 and 2.34, 1.04 to 5.28) (multivariate analysis, 95% CI).ConclusionsAPACHE II score, PaO2/FiO2 ratio, LDH, WBC count and oxygen therapy before AE were deemed as prognostic factors of AE of IPF. Although there are some methodological limitations in this study, these findings are reliable due to consistent results by both univariate and multivariate analyses.PROSPERO registration numberCRD42018106172.

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Section: Discussionmentioning

confidence: 96%

Systematic review and meta-analysis of prognostic factors of acute exacerbation of idiopathic pulmonary fibrosis

Kamiya

Panlaqui

2020

BMJ Open

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“…AE‐IPF is a life‐threatening event; the 90‐day survival rate ranged from approximately 20% to 70% . Although the reported short‐term survival rate is variable, it likely depends on differences in the diagnostic criteria of AE‐IPF, baseline characteristics of the study population, study design and supportive therapy, among others.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of corticosteroid and intravenous cyclophosphamide in acute exacerbation of idiopathic pulmonary fibrosis: A propensity score‐matched analysis

et al. 2019

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Background and objective: Acute exacerbation (AE) is a leading cause of death in patients with idiopathic pulmonary fibrosis (IPF). Although optimal treatment for AE-IPF remains unclear, high-dose corticosteroids (CS) with/without immunosuppressants, including intravenous cyclophosphamide (IVCY), are often used as empirical therapy. However, the survival benefit of adding IVCY to CS therapy is unknown. We investigated the efficacy of this therapy in patients with AE-IPF. Methods: Overall, 102 consecutive patients with IPF with a first idiopathic AE were included. Post-AE survival rates and treatment safety were retrospectively assessed. Efficacy of CS + IVCY therapy for the first AE was compared with that of CS monotherapy using a propensity score-matched analysis. Results: The post-AE 90-day survival rate of the entire cohort was 64.7%. On the basis of the propensity scores, 26 matched patient pairs were made. Characteristics of matched patients with AE-IPF treated with CS (matched CS group) and those with CS + IVCY (matched CS + IVCY group) were well balanced. No significant between-group differences were observed in post-AE 90-day survival rates (84.6% vs 76.9%; P = 0.70), cumulative survival rates (P = 0.57 by log-rank test) or incidence of adverse events ≥ CTCAE (Common Terminology Criteria for Adverse Events) v5.0 grade 3 (61.5% vs 65.4%; P = 1.00). Conclusion: The propensity score-matched analysis demonstrated that compared with CS monotherapy, CS + IVCY therapy did not significantly improve post-AE survival in patients with AE-IPF. Further studies are warranted to assess the efficacy of CS + IVCY therapy for AE-IPF.A propensity score-matched analysis demonstrated that in patients with idiopathic pulmonary fibrosis with a first episode of idiopathic acute exacerbation, compared with corticosteroids (CS) monotherapy, CS plus intravenous cyclophosphamide (IVCY) therapy did not significantly improve their survival. This suggests that routine use of IVCY with CS is not recommended.

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“…A historically controlled study was conducted in AE‐IPF patients comparing patients who received the recombinant human soluble thrombomodulin (rhTM) to those who did not allow to consider the addition of rhTM to conventional treatment in future studies because of the improved overall survival. Also, the prognostic significance of Glasgow Coma Scale (GCS) has been proved to help predict mortality in AE‐IPF probably as it is representative of the host immune response.…”

Section: Idiopathic Pulmonary Fibrosismentioning

confidence: 99%

Contemporary Concise Review 2018: Interstitial lung disease

2019

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Prognostic significance of Glasgow prognostic score in patients with acute exacerbation of idiopathic pulmonary fibrosis

Abstract: GPS can be helpful in predicting mortality in IPF patients with AE.

Cited by 28 publications

References 45 publications

Systematic review and meta-analysis of prognostic factors of acute exacerbation of idiopathic pulmonary fibrosis

Systematic review and meta-analysis of prognostic factors of acute exacerbation of idiopathic pulmonary fibrosis

Efficacy of corticosteroid and intravenous cyclophosphamide in acute exacerbation of idiopathic pulmonary fibrosis: A propensity score‐matched analysis

Contemporary Concise Review 2018: Interstitial lung disease

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