Titrated oxygen requirement and prognostication in idiopathic pulmonary fibrosis

Hook, Jaime; Arcasoy, Selim M.; Zemmel, David; Bartels, Matthew N.; Kawut, Steven M.; Lederer, David J.

doi:10.1183/09031936.00108111

Cited by 40 publications

(27 citation statements)

References 25 publications

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“…A higher titrated oxygen requirement to maintain oxyhemoglobin saturation (arterial oxygen saturation measured by pulse oximetry [SpO 2 ]) 96% at rest is associated with a greater mortality rate in patients with IPF independent of FVC and 6MWD [51].…”

Section: Use Of Supplemental Oxygenmentioning

confidence: 99%

Natural history of idiopathic pulmonary fibrosis

Kim

Perlman

Tomic

2015

Respiratory Medicine

137

109

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Idiopathic pulmonary fibrosis (IPF) is a parenchymal lung disease characterized by progressive interstitial fibrosis. IPF has a poor prognosis, with a median survival time of 2-3 years from diagnosis, but varying from a few months to a decade. The natural history of IPF is highly variable and the course of disease in an individual patient is difficult to predict. Some patients with IPF experience rapid decline, others progress much more slowly, and some patients show periods of relative stability interspersed with acute deteriorations in respiratory function. Many clinical, radiographic, serologic, and histopathologic variables have been shown to predict mortality in IPF. However, the accuracy of these predictors varies due to the retrospective nature of some of the studies and variations in study design. The ability to identify clinical characteristics that predict disease progression and survival would be useful for counseling patients, treatment decision-making, and prompt consideration for lung transplantation. A number of indices for predicting mortality in patients with IPF are available, but they require further validation. As high-resolution computed tomography scans become more widely available and patients with IPF are diagnosed earlier, survival times following diagnosis will improve. Early referral to interstitial lung disease specialty centers is important for accurate diagnosis and may be associated with improved outcomes. The goal of this review is to examine the natural history of IPF, discuss predictors of mortality, and highlight the importance of prompt diagnosis and referral for patients with IPF.

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Section: Use Of Supplemental Oxygenmentioning

confidence: 99%

Natural history of idiopathic pulmonary fibrosis

Kim

Perlman

Tomic

2015

Respiratory Medicine

137

109

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“…Several studies have identified independent predictors of mortality in patients with IPF, including age, respiratory hospitalisation, forced vital capacity (FVC) % predicted, and longitudinal change in FVC % pred [5][6][7][8][9][10][11][12][13][14][15][16]. The 6-min walk distance (6MWD), a practical and widely used measure of clinical status in patients with a variety of cardiopulmonary diseases [17][18][19][20][21][22], has recently been shown to be associated with the risk of mortality in patients with IPF [23][24][25]; however, the independent contribution of 6MWD to the risk of mortality has not been formally evaluated in a large, well-defined population of patients with IPF.…”

Section: Introductionmentioning

confidence: 99%

6-minute walk distance is an independent predictor of mortality in patients with idiopathic pulmonary fibrosis

Bois

Albera

Bradford³

et al. 2013

European Respiratory Journal

187

163

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6-min walk distance (6MWD) has recently been shown to be associated with the risk of mortality in patients with idiopathic pulmonary fibrosis (IPF); however, the independent contribution of 6MWD to the prediction of mortality risk has not been evaluated in a large, well-defined population of patients with IPF.A Cox proportional hazards model was used to characterise the relationship between risk factors of interest and all-cause mortality in IPF patients who completed a week 24 study visit in a clinical trial evaluating interferon c-1b (n5748). Risk factors of interest included the independent predictors of mortality in the previously published clinical prediction model together with 6MWD and 24-week change in 6MWD.Baseline 6MWD ,250 m was associated with a two-fold increase in the risk of mortality (hazard ratio 2.12, 95% CI 1.15-3.92) and a 24-week decline in 6MWD .50 m was associated with a nearly threefold increase in mortality risk (hazard ratio 2.73; 95% CI 1.60-4.66). Inclusion of 6MWD data improved model discrimination compared with the original model (C-statistic 0.80 (95% CI 0.76-0.85) versus 0.75 (0.71-0.79)).Both 6MWD and change in 6MWD are independent predictors of mortality in patients with IPF. The addition of 6MWD to the clinical prediction model improves model discrimination compared with the original model. @ERSpublications 6MWD indices independently predict mortality in IPF and improve performance of previous clinical prediction model

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“…The titrated oxygen requirement and 6-min walk test distance were independent predictors of survival. A higher titrated oxygen requirement was associated with a greater mortality rate independent of FVC and 6-min walk test results in IPF (adjusted HR 1.16, 95% CI 1.06-1.27 L?min -1 ) [38]. The supplemental oxygen flow rate had a prognostic significance comparable to that of DLCO, oxyhaemoglobin saturation at the end of 6-min walk test and heart rate recovery.…”

Section: Prognosis Of Ipfmentioning

confidence: 82%

“…HOOK et al [38] assessed whether oxygen requirement could be used as a tool for prognostication in patients with IPF. Oxygen requirements were standardised, and titrated oxygen requirement was defined as the lowest oxygen flow rate required to maintain an oxyhaemoglobin saturation of 96% while standing, immediately prior to 6-min walk testing.…”

Section: Prognosis Of Ipfmentioning

confidence: 99%

Interstitial lung disease

Cottin

2013

European Respiratory Review

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Titrated oxygen requirement and prognostication in idiopathic pulmonary fibrosis

Cited by 40 publications

References 25 publications

Natural history of idiopathic pulmonary fibrosis

Natural history of idiopathic pulmonary fibrosis

6-minute walk distance is an independent predictor of mortality in patients with idiopathic pulmonary fibrosis

Interstitial lung disease

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