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Idiopathic Pulmonary Fibrosis*: Survival as a Function of Oxygen Therapy and Treatment Program FREE TO VIEW

William W. Douglas, MD; Jay H. Ryu, MD, FCCP; Darrell R. Schroeder, MS
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*From the Mayo Clinic, Rochester, MN.

Correspondence to: William W. Douglas, MD, Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First St NW, Rochester, MN 55905

Chest. 2001;120(1_suppl):S62. doi:10.1378/chest.120.1_suppl.S62
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We reviewed the clinical records of 487 patients with a diagnosis of idiopathic pulmonary fibrosis of the usual interstitial pneumonia type confirmed by findings on CT scan (94.7%) or surgical lung biopsy specimens (20.3%) during the years 1994 to 1996. We compared survival in these patients as a function of treatment program based on intent to treat at the time of the initial visit within the study window. Treatment with colchicine alone was advised for 167 patients, no therapy was used in 157 patients, prednisone at maintenance doses alone was prescribed in 54 patients, colchicine plus prednisone was prescribed in 71 patients, and other programs were used in 38 patients. Oxygen therapy was advised in 133 of these patients. By univariate analysis, we found that survival was significantly worse for patients treated with prednisone than with no therapy and for patients receiving oxygen therapy compared to those for whom oxygen was not advised. However, on multivariate analysis, we found that worse survival was associated with male gender, increasing age, lower carbon monoxide diffusing capacity, lower alveolar volume, and a history of worsening pulmonary function. When these factors were included in a multivariate analysis, we found no significant differences in survival between patients treated with colchicine or prednisone and those receiving no therapy. Similarly, we found no difference in survival between patients receiving oxygen and those not so treated.




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