HRCT findings predict 1-year mortality in patients with acute exacerbation of idiopathic inflammatory myopathies-associated interstitial lung disease
Jingping Zhang,
Liyu He,
Tingting Han,
Jiayin Tong,
Jialiang Ren,
Jiantao Pu,
Ming Zhang,
Youmin Guo,
Chenwang Jin
Affiliations
Jingping Zhang
Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, 710061, PR China
Liyu He
Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, 710061, PR China
Tingting Han
Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, 710061, PR China
Jiayin Tong
Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, 710061, PR China
Jialiang Ren
GE Healthcare China, Daxing District, Tongji South Road No.1, Beijing, 100176, PR China
Jiantao Pu
Department of Radiology and Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, 15213, USA
Ming Zhang
Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, 710061, PR China; Shaanxi Engineering Research Center of Computational Imaging and Medical Intelligence, 277 Yanta West Road, Xi'an, Shaanxi, 710061, PR China
Youmin Guo
Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, 710061, PR China; Shaanxi Engineering Research Center of Computational Imaging and Medical Intelligence, 277 Yanta West Road, Xi'an, Shaanxi, 710061, PR China
Chenwang Jin
Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, 710061, PR China; Shaanxi Engineering Research Center of Computational Imaging and Medical Intelligence, 277 Yanta West Road, Xi'an, Shaanxi, 710061, PR China; Corresponding author. Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, 710061, PR China.
Background: Acute exacerbation of idiopathic inflammatory myopathies-associated interstitial lung disease (AE-IIM-ILD) is a significant event associated with increased morbidity and mortality. However, few studies investigated the potential prognostic factors contributing to mortality in patients who experience AE-IIM-ILD. Objectives: The purpose of our study was to comprehensively investigate whether high-resolution computed tomography (HRCT) findings predict the 1-year mortality in patients who experience AE-IIM-ILD. Methods: A cohort of 69 patients with AE-IIM-ILD was retrospectively created. The cohort was 79.7 % female, with a mean age of 50.7. Several HRCT features, including total interstitial lung disease extent (TIDE), distribution patterns, and radiologic ILD patterns, were assessed. A directed acyclic graph (DAG) was used to evaluate the statistical relationship between variables. The Cox regression method was performed to identify potential prognostic factors associated with mortality. Results: The HRCT findings significantly associated with AE-IIM-ILD mortality include TIDE (HR per 10%-increase, 1.64; 95%CI, 1.29–2.1, p < 0.001; model 1: C-index, 0.785), diffuse distribution pattern (HR, 3.75, 95%CI, 1.5–9.38, p = 0.005; model 2: C-index, 0.737), and radiologic diffuse alveolar damage (DAD) pattern (HR, 6.37, 95 % CI, 0.81–50.21, p = 0.079; model 3: C-index, 0.735). TIDE greater than 58.33 %, diffuse distribution pattern, and radiologic DAD pattern correlate with poor prognosis. The 90-day, 180-day, and 1-year survival rates of patients who experience AE-IIM-ILD were 75.3 %, 66.3 %, and 63.3 %, respectively. Conclusion: HRCT findings, including TIDE, distribution pattern, and radiological pattern, are predictive of 1-year mortality in patients who experience AE-IIM-ILD.
