Clinical and Radiological Predictors of Mortality in Patients with Interstitial Lung Disease
Abstract
Background: Interstitial lung disease (ILD) includes a diverse group of pulmonary disorders associated with progressive fibrosis, functional decline and increased mortality. Identifying clinical and radiological predictors of poor outcomes may help improve risk assessment and follow-up strategies.
Objective: To determine the clinical and radiological predictors associated with mortality in patients with interstitial lung disease.
Methodology: A retrospective observational study was conducted in the Department of Pulmonology, Saidu Teaching General Hospital Swat, from June 2024 to December 2024. A total of 350 adult patients diagnosed with ILD were included through consecutive sampling. Demographic characteristics, clinical features, pulmonary function parameters, HRCT findings, comorbidities and treatment-related variables were collected. Associations with mortality were assessed using descriptive statistics, independent sample t-test, chi-square test and comparative analysis between survivors and non-survivors.
Results: Among 350 patients, 301(86.0%) were alive and 49(14.0%) died during follow-up. The mean age of the study population was 56.48±9.85 years, with 214(61.1%) males and 136(38.9%) females. Idiopathic pulmonary fibrosis was the most common ILD subtype, observed in 154(44.0%) patients. Non-survivors showed lower FVC (73.57±13.80 vs 76.59±13.20, p=0.124), lower DLCO (57.04±15.70 vs 59.98±15.10, p=0.216), reduced six-minute walk distance (378.00±109.80 vs 406.43±111.30, p=0.096) and greater fibrosis extent (44.65±17.31 vs 39.75±16.74, p=0.069) compared with survivors. UIP pattern was significantly associated with mortality (χ²=7.01, p=0.008). ILD subtype was also significantly associated with mortality (p=0.033).
Conclusion: Mortality in patients with ILD is influenced by clinical severity and radiological characteristics. UIP pattern and ILD subtype showed significant associations with mortality, while reduced lung function, extensive fibrosis and impaired functional capacity demonstrated clinically important trends. Comprehensive assessment using clinical and HRCT parameters may support early identification of high-risk patients and improve follow-up strategies.
Keywords: Interstitial Lung Disease; Pulmonary Fibrosis; Idiopathic Pulmonary Fibrosis; High-Resolution Computed Tomography; Mortality
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