Prognostic implication of 1-year decline in diffusing capacity in newly diagnosed idiopathic pulmonary fibrosis

The progression of idiopathic pulmonary fibrosis (IPF) is assessed through serial monitoring of forced vital capacity (FVC). Currently, data regarding the clinical significance of longitudinal changes in diffusing capacity for carbon monoxide (DLCO) is lacking. We investigated the prognostic implica...

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Bibliographic Details
Published in:Scientific reports 2024-04, Vol.14 (1), p.8857-8857, Article 8857
Main Authors: Lee, Hyeonsu, Kim, So Yeon, Park, Young Sik, Choi, Sun Mi, Lee, Jong Hyuk, Park, Jimyung
Format: Article
Language:English
Subjects:
631/443/1784
692/699/1785
Carbon monoxide
Diagnosis
Disease progression
Emphysema
Fibrosis
Humanities and Social Sciences
Hypertension
Idiopathic pulmonary fibrosis
Lung diseases
multidisciplinary
Patients
Pulmonary diffusing capacity
Pulmonary fibrosis
Respiratory function test
Science
Science (multidisciplinary)
Vital capacity
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Summary:The progression of idiopathic pulmonary fibrosis (IPF) is assessed through serial monitoring of forced vital capacity (FVC). Currently, data regarding the clinical significance of longitudinal changes in diffusing capacity for carbon monoxide (DLCO) is lacking. We investigated the prognostic implications of a 1-year decline in DLCO in 319 patients newly diagnosed with IPF at a tertiary hospital between January 2010 and December 2020. Changes in FVC and DLCO over the first year after the initial diagnosis were reviewed; a decline in FVC ≥ 5% and DLCO ≥ 10% predicted were considered significant changes. During the first year after diagnosis, a significant decline in FVC and DLCO was observed in 101 (31.7%) and 64 (20.1%) patients, respectively. Multivariable analysis showed that a 1-year decline in FVC ≥ 5% predicted (aHR 2.74, 95% CI 1.88–4.00) and 1-year decline in DLCO ≥ 10% predicted (aHR 2.31, 95% CI 1.47–3.62) were independently associated with a higher risk of subsequent mortality. The prognostic impact of a decline in DLCO remained significant regardless of changes in FVC, presence of emphysema, or radiographic indications of pulmonary hypertension. Therefore, serial monitoring of DLCO should be recommended because it may offer additional prognostic information compared with monitoring of FVC alone.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-024-59649-5