Diffuse Lung Disease |

GAP Index for Idiopathic Pulmonary Fibrosis in a Portuguese Cohort FREE TO VIEW

Margarida Redondo, MD; Natalia Melo, MD; Diogo Costa, PhD; Patricia Mota, MD; Antonio Morais, MD
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Centro Hospitalar de São João, Porto, Portugal

Chest. 2014;145(3_MeetingAbstracts):255A. doi:10.1378/chest.1825339
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SESSION TYPE: Slide Presentations

PRESENTED ON: Saturday, March 22, 2014 at 12:15 PM - 01:15 PM

PURPOSE: Patients with Idiopathic Pulmonary Fibrosis (IFP) demonstrate widely variable clinical courses and survival. Thus, predicting prognosis in patients with IPF is a challenge for clinicians. Multidimensional GAP (gender, age and 2 lung physiology variables [FVC and DLCO]) index and staging system was developed to predict mortality in IPF. The purpose of this study is to use GAP multidimensional index in IPF patients observed in recent years in our Interstitial Lung Diseases (ILD) outpatient clinic and understand if our results go in line with the published data.

METHODS: Eighty two patients with IPF diagnosis according to the ATS/ERS criteria were included. Medical records were retrospectively analyzed. Patients were characterized by clinical and physiological findings, at the time of diagnosis. Patients were censored at death or lung transplant and classified according to the 3 stages of the GAP index. Hazard Ratios (HR), 95% Confidence intervals (95%CI) were computed using univariate Cox regression models to estimate the risk of being classified in stages II and III after 12, 24, 36, 48 and 60 months of follow-up.

RESULTS: From eighty two patients included, 72% were males, with a mean age at diagnosis of 67.2±10.6 years old. Forty-six deaths and 6 lung transplantations occurred. FVC and DLCO at diagnosis were 74.8±17.5% and 45.7±17.8%, respectively. According to the stages of the GAP index: 36 patients were classified in stage I, 39 patients in stage II and 7 patients in stage III. Median follow-up was 29.1 months (range, 2 to 123 months). An increase in the HR (95%CI) estimates was observed according to GAP stages and follow-up time. Compared to stage I patients, at 60 months, HR (95%CI) for stage II and stage III patients were 1.37 (0.72-2.59) and 3.46 (1,42-8.47).

CONCLUSIONS: In this Portuguese sample, the GAP index was useful to classify patient according to prognosis severity. Larger samples and adjustment for known confounders might be needed to accurately test this index prognostic value.

CLINICAL IMPLICATIONS: GAP index can be used to properly identify the disease severity of an IPF patient.

DISCLOSURE: The following authors have nothing to disclose: Margarida Redondo, Natalia Melo, Diogo Costa, Patricia Mota, Antonio Morais

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