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T. Fujikawa1, S. Misu2, K. Otake1, H. Sakai1
1Kobe City Medical Center West Hospital, Rehabilitation, Kobe, Japan, 2Konan Women's University, Physical Therapy, Faculty of Nursing and Rehabilitation, Kobe, Japan
Background: Low skeletal muscle mass is a risk factor for poor clinical outcome in various lung diseases. However, a few studies have been conducted on patients with idiopathic pulmonary fibrosis (IPF).
Purpose: We aimed to investigate whether skeletal muscle mass, derived from chest computed tomography (CT), can be a predictor of mortality in IPF.
Methods: We retrospectively investigated the medical records of the patients diagnosed with IPF between January 2010 and December 2018, and surveyed severity of the disease (GAP index) and survival time from diagnosis to two years. Skeletal muscle volumes were measured by using the cross-sectional area of pectoralis muscle at the level of pulmonary artery bifurcation, derived from chest CT at the time of diagnosis. Pectoralis muscle index (PMI) was calculated by dividing the area by height in meters squared. Cox proportional hazards models were performed to investigate relationships between PMI and all-cause mortality.
Results: A total of 80 patients [median age: 74.2 (IQR, 72-80) years at diagnosis; 79% male] were enrolled. Eight patients died within 2 years. In the univariate Cox regression analysis, PMI and GAP index were significant risk factors for all-cause mortality. In the multivariate analysis, PMI was a significant risk factor for all-cause mortality (HR, 0.56; 95% CI, 0.35 – 0.89; p = 0.01), whereas GAP index was not (HR, 1.47; 95% CI, 0.99-2.18; p > 0.05).
Conclusion(s): Low skeletal mass normalized for stature derived from single-slice axial chest CT, may be a strong risk factor for all-cause mortality in patients with IPF.
Implications: In IPF, in addition to respiratory function, skeletal muscle mass also affects prognosis, and maintaining or increasing skeletal muscle mass from the time of diagnosis may contribute to improving prognosis.
Funding, acknowledgements: This work was funded by a grant from Hyogo Physical Therapy Association.
Keywords: IPF, skeletal muscle mass, prognosis
Topic: Cardiorespiratory
Did this work require ethics approval? Yes
Institution: Department of Rehabilitation, Kobe City Medical Center West Hospital, Kobe
Committee: Kobe City Medical Center West Hospital, Kobe
Ethics number: 20-008
All authors, affiliations and abstracts have been published as submitted.
