New prognostic scoring system for mortality in idiopathic pulmonary fibrosis by modifying the gender, age, and physiology model with desaturation during the six-minute walk testopen access
- Authors
- Lee, Jae Ha; Jang, Ji Hoon; Jang, Hang-Jea; Kim, Song Yee; Chung, Man Pyo; Yoo, Hongseok; Jeong, Sung Hwan; Song, Jin Woo; Lee, Hong Lyeol; Choi, Sun Mi; Kim, Young Whan; Kim, Yong Hyun; Park, Sung Woo; Park, Jong Sun; Jegal, Yangin; Lee, Jongmin; Uh, Soo-Taek; Kim, Tae-Hyung; Kim, Yee Hyung; Shin, Beomsu; Lee, Hyun-kyung; Yang, Sei-Hoon; Lee, Hyun; Kim, Sang-Heon; Lee, Eun-Joo; Choi, Hye Sook; Kang, Hyung Koo; Heo, Eun Young; Lee, Won-Yeon; Park, Moo Suk
- Issue Date
- Jan-2023
- Publisher
- Frontiers Media S.A.
- Keywords
- idiopathic pulmonary fibrosis; interstitial lung disease; mortality; prognosis; six-minute walk test
- Citation
- Frontiers in Medicine, v.10
- Indexed
- SCIE
SCOPUS
- Journal Title
- Frontiers in Medicine
- Volume
- 10
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/62496
- DOI
- 10.3389/fmed.2023.1052129
- ISSN
- 2296-858X
- Abstract
- Background
Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial lung disease (ILD) with variable and heterogeneous clinical course. The GAP (gender, age, and physiology) model had been used to predict mortality in patients with IPF, but does not contain exercise capacity. Therefore, our aim in this study was to develop new prognostic scoring system in the Korea IPF Cohort (KICO) registry.
Materials and methods
This is a retrospective study of Korean patients with IPF in KICO registry from June 2016 to August 2021. We developed new scoring system (the GAP6) based on the GAP model adding nadir saturation of percutaneous oxygen (SpO2) during six-minute walk test (6MWT) in the KICO registry and compared the efficacy of the GAP and the GAP6 model.
Results
Among 2,412 patients in KICO registry, 966 patients were enrolled. The GAP6 model showed significant prognostic value for mortality between each stage [HR Stage II vs. Stage I = 2.89 (95% CI = 2.38–3.51), HR Stage III vs. Stage II = 2.68 (95% CI = 1.60–4.51)]. In comparison the model performance with area under curve (AUC) using receiver operating characteristic (ROC) curve analysis, the GAP6 model showed a significant improvement for predicting mortality than the GAP model (AUC the GAP vs. the GAP6, 0.646 vs. 0.671, p < 0.0019). Also, the C-index values slightly improved from 0.674 to 0.691 for mortality.
Conclusion
The GAP6 model adding nadir SpO2 during 6WMT for an indicator of functional capacity improves prediction ability with C-index and AUC. Additional multinational study is needed to confirm these finding and validate the applicability and accuracy of this risk assessment system.
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- Appears in
Collections - 2. Clinical Science > Department of Pulmonary, Allergy, and Critical Care Medicine > 1. Journal Articles
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