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Are risk predicting models useful for estimating survival of patients with rheumatoid arthritis-associated interstitial lung disease?

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Date
2017
Author
Nurmi Hanna M
Purokivi Minna K
Kärkkäinen Miia S
Kettunen Hannu-Pekka
Selander Tuomas A
Kaarteenaho Riitta L
Unique identifier
10.1186/s12890-016-0358-2
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Citation
Nurmi Hanna M. Purokivi Minna K. Kärkkäinen Miia S. Kettunen Hannu-Pekka. Selander Tuomas A. Kaarteenaho Riitta L. (2017). Are risk predicting models useful for estimating survival of patients with rheumatoid arthritis-associated interstitial lung disease?.  BMC PULMONARY MEDICINE, 17 (1) , 1-9. 10.1186/s12890-016-0358-2.
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CC BY http://creativecommons.org/licenses/by/4.0/
Abstract

Background
Risk predicting models have been applied in idiopathic pulmonary fibrosis (IPF), but still not validated in patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD). The purpose of this study was to test the suitability of three prediction models as well as individual lung function and demographic factors for evaluating the prognosis of RA-ILD patients.

Methods
Clinical and radiological data of 59 RA-ILD patients was re-assessed. GAP (gender, age, physiologic variables) and the modified interstitial lung disease (ILD)-GAP as well as the composite physiologic indexes (CPI) were tested for predicting mortality using the goodness-of-fit test and Cox model. Potential predictors of mortality were also sought from single lung function parameters and clinical characteristics.

Results
The median survival was 152 and 61 months in GAP / ILD-GAP stages I and II (p = 0.017). Both GAP and ILD-GAP models accurately estimated 1-year, 2-year and 3-year mortality. CPI (p = 0.025), GAP (p = 0.008) and ILD-GAP (p = 0.028) scores, age (p = 0.002), baseline diffusion capacity to carbon monoxide (DLCO) (p = 0.014) and hospitalization due to respiratory reasons (p = 0.039), were significant predictors of mortality in the univariate analysis, whereas forced vital capacity (FVC) was not predictive. CPI score (HR 1.03, p = 0.018) and baseline DLCO (HR 0.97, p = 0.011) remained significant predictors of mortality after adjusting for age.

Conclusions
GAP and ILD-GAP are applicable for evaluating the risk of death of patients with RA-ILD in a similar manner as in those with IPF. Baseline DLCO and CPI score also predicted survival.

Subjects
Mortality   Rheumatoid arthritis   Interstitial lung disease   Interstitial lung disease   RA-ILD   GAP   ILD-GAP   Composite physiologic index   
URI
https://erepo.uef.fi/handle/123456789/3711
Link to the original item
http://dx.doi.org/10.1186/s12890-016-0358-2
Publisher
Springer Nature
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  • Terveystieteiden tiedekunta
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