Study on the relationship between radiological fibrosis score in high-resolution computed tomography and the survival in rheumatoid arthritis-related interstitial lung disease
10.3760/cma.j.issn.1007-7480.2018.11.008
- VernacularTitle:肺高分辨率CT评分对类风湿关节炎相关间质性肺疾病患者预后的分析
- Author:
Chengqiang ZHANG
1
;
Lihua FANG
;
Xiaoping LIU
;
Tingting NIE
;
Rui LI
;
Luping CUI
;
Jie WANG
Author Information
1. 山西省人民医院风湿免疫科
- Keywords:
Arthritis;
rheumatoid;
Lung diseases;
interstitial;
High resolution CT
- From:
Chinese Journal of Rheumatology
2018;22(11):757-762
- CountryChina
- Language:Chinese
-
Abstract:
Objective Idiopathic pulmonary fibrosis, the fibrosis score (i.e., the combined extent of reticulation and honeycombing) is associated with worse survival. The aim of this study was to identify high-resolution computed tomography (HRCT) patterns and patient characteristics that could predict poor prognosis in rheumatoid arthritis-related ILD (RA-ILD). Methods We retrospectively analyzed 130 patients with newly diagnosed RA-ILD from 2011 to 2017 at Shanxi People's Hospital. The Pearson correlation analysis was used for the correlation between the fibrosis score and the worse survival of RA-ILD, and Using Cox regression analysis was used to identify the associations with mortality. A value of P less than 0.05 was considered statistically significant. Results During a median follow-up of 65 months, 32/130 (24.6％) patients died. Univariate analysis identified 6 significant poor prognostic factors: lower baseline ％ predicted forced vital capacity [HR=0.97, 95％CI(0.94, 0.99);P=0.008], total interstitial disease score [HR=1.06, 95％CI(1.03, 1.08);P<0.01], reticulation score [HR=1.07, 95％CI (1.04, 1.09); P<0.01], traction bronchiectasis score [HR=2.04, 95％CI (1.21, 3.40);P=0.008], fibrosis score [HR=1.07, 95％CI (1.01, 1.13);P<0.01], and definite UIP pattern [HR=4.18, 95％CI (1.40, 12.51); P=0.010]. Fibrosis score remained to be an independent significant poor prognostic factor of survival on bivariate analysis [HR=8.136, 95％CI (2.87, 28.35); P=0.001]. Patients with a fibrosis score>20％ had high mortality. Conclusion This study has shown that fibrosis score is strongly associated with worse survival in RA-ILD, and patients with fibrosis score>20％ have a 8.136-fold increased risk of mortality.
