Predicating The Mortality Risk Of Idiopathic Pulmonary Fibrosis Through Baseline Clinical Characteristics

Background:Idiopathic pulmonary fibrosis is a specific type of chronic progressing fibrosing interstitial pneumonia with unknown aetiology and poor prognosis.At present,the clinical goal is mainly to stabilize the disease and slow its progress.In recent years,a large number of clinical studies on IPF emerged.Genetic polymorphisms,plasma markers,dynamic clinical characteristics,and baseline clinical characteristics of patients have been used to predict the prognosis of IPF with the effort and cooperation of pulmonary interstitial diseases researchers all around the world.Compared to the genetic polymorphisms,plasma markers and dynamic clinical characteristics,the baseline clinical characteristics of patients do not require special means of detection,and they are more convenient and fast.In view of this,this paper focuses on the meta-analysis of the four categories(including age,gender and Body Mass Index,respiratory symptoms,pulmonary function,imaging)of the baseline clinical characteristics that can be obtained quickly when IPF patients are newly diagnosed,and evaluate the predictive value of these characteristics for the mortality risk in IPF patients.Methods:A total of 32 related studies were included via searching the online database(including the Pubmed database,Embase database,Vip database,Wanfang database).The overall mortality risk ratio and the corresponding 95%confidence interval(95%CI)were summarized and analyzed by meta-analysis.Results:Among the 10 included clinical characteristics,9 of them exist statistic differences.The results were expressed as HR and its 95%confidence interval:age(HR =1.03,95%confidence interval 1.01-1.05,p = 0.002),Body Mass Index(HR = 0.96,95%confidence interval 0.94-0.98,p<0.0001),forced vital capacity of the percentage predicted value(HR = 0.98,95%confidence interval 0.97-0.98,p<0.00001),carbon monoxide diffused amount of the percentage predicted value HR = 0.98,95%confidence interval 0.96-0.99,p<0.0001),dyspnea score scale(HR = 1.63,95%confidence interval 1.20-2.21,p = 0.002),emphysema(HR = 1.34,95%confidence interval 1.02-1.76,p=0.04),honeycombing imaging(HR = 1.06,95%confidence interval 1.01-1.11,p = 0.02),pulmonary fibrosis score(HR = 1.27,95%confidence interval 1.01-1.58,p = 0.04),pulmonary arterial hypertension(HR = 1.22,95%confidence interval 1.67-6.18,p = 0.005),while in the sex group,men were not significantly different from women in mortality risk(HR = 1.22,95%confidence interval 1.00-1.50,p = 0.05).Conclusions:In this article,by means of meta-analysis,we demonstrated that the baseline clinical characteristics(including age,body mass index,lung function,symptoms,imaging findings)of IPF patients may well predict their mortality risk and survival time.And on the other hand,we believe that designing a multidimensional scoring system based on the above results may help to predict the risk of death and survival time for patients with idiopathic pulmonary fibrosis.