ARTÍCULOS DE INVESTIGACIÓN - Supervivencia de pacientes con fibrosis pulmonar idiopática diagnosticadospor biopsia quirúrgica de pulmón: experiencia del Instituto Nacional del Tórax

Enero 2014

art í aaccccddeeggiiiilnosttuv ón 9 Rev Med Chile 2014; 142: 9-15 Supervivencia de pacientes con fibrosis pulmonar idiopática diagnosticados por biopsia quirúrgica de pulmón: experiencia del Instituto Nacional del Tórax Mauricio Salinas, Matías Florenzano, Eduardo Sabbagh, Manuel Meneses, Cristina Fernández, Alfredo Jalilie, Juan Carlos Rodríguez, Gabriel Cavadaa, Álvaro Undurraga Survival of patients with biopsy-proven idiopathic pulmonary fibrosis: Chilean National Thorax Institute experience Background: Idiopathic Pulmonary Fibrosis (IPF) is the most prevalent of all interstitial lung diseases. The usual underlying pathological picture is an interstitial pneumonia (UIP). Aim: To describe the evolution of a Chilean cohort of patients with IPF. Material and Methods: Patients with the disease were identified at the pathology registry of National Institute of Thoracic Diseases, Santiago, Chile. Patients were included if they had surgical biopsy of UIP and compatible clinical and radiological characteristics. The medical records of included patients were reviewed, recording clinical information and lung function test results. Survival was analyzed obtaining death records from the Chilean National Identification Service. Results: Data from 142 patients with a mean age of 58 years (42% men), were analyzed. Mean initial lung function showed a forced vital capacity (FVC) of 73%, carbon monoxide diffusing capacity (DLCO) of 57% and a distance covered in 6-minute walk (6MWT) of 95% of expected normal values. The median survival was 80 months. Predictors of survival were a DLCO of less than 40% and an oxygen saturation at the end of the 6MWT of less than 89%. Conclusions: Survival in this group of patients was higher than the figures reported elsewhere. DLCO and the fall of oxygen saturation after walking were predictors of mortality, as previously described in other populations. (Rev Med Chile 2014; 142: 9-15) Key words: Disease progression; Idiopathic pulmonary fibrosis; Survival analysis. Instituto Nacional del Tórax. aPhD Estadística. Recibido el 4 octubre de 2012, aceptado el 13 de diciembre de 2013. Correspondencia a: Dr. Álvaro Undurraga Pereira. Roberto del Río 1918, Santiago, Chile. Teléfono: 9-8223434. alvaroundurragap@yahoo.com La fibrosis pulmonar idiopática (FPI) es una enfermedad de relativamente baja prevalencia. A pesar que no hay datos en el país, sabemos que esta enfermedad aumenta con la edad y por lo tanto, el cambio de la situación epidemiológica ocurrida en Chile en los últimos 20 años, explica que pacientes con FPI se vean con más frecuencia hoy, en casi todos los servicios de medicina de los hospitales chilenos. La prevalencia reportada de la enfermedad es variable, entre 14 y 42 casos por 100.000 habitantes1. Se conoce que es más frecuente en el sexo masculino y se presenta a una edad media de 66 años2. La enfermedad se inicia en forma caracte


Enero 2014
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