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Lung India Official publication of Indian Chest Society  
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Year : 2021  |  Volume : 38  |  Issue : 1  |  Page : 5-11

Survival predictors of interstitial lung disease in India: Follow-up of Interstitial Lung Disease India registry

1 Department of Chest and Tuberculosis, SMS Medical College, Jaipur, Rajasthan, India
2 Department of Community Medicine, All India Institute of Medical Sciences, New Delhi, India
3 Department of Medicine, Center for Interstitial Lung Diseases, University of Washington, Seattle, WA, USA
4 Department of Medicine, SMS Medical College, Jaipur, Rajasthan, India
5 Department of Pulmonary Medicine, Topiwala National Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India
6 Department of Pulmonary and Sleep Care Medicine, Metro Multispeciality Hospital, Noida, Uttar Pradesh, India
7 Department of Pulmonary Medicine, Asthma Bhawan, Jaipur, Rajasthan, India
8 Jankharia Imaging Center, Mumbai, Maharashtra, India
9 Department of Respiratory Medicine, Institute of Pulmocare and Research, Kolkata, West Bengal, India
10 Department of Respiratory Medicine, JLN Medical College and Hospital, Ajmer, Rajasthan, India
11 Department of Pulmonary Medicine, Government Medical College, Kozhikode, Kerala, India
12 Department of Respiratory Medicine, National Allergy Asthma Bronchitis Institute, Kolkata, West Bengal, India
13 Department of Pulmonary Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
14 Department of Internal and Pulmonary Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
15 Department of Pulmonology and Critical Care, Fortis Hospital, Kolkata, West Bengal, India
16 Department of Respiratory, Critical Care, Sleep Medicine and Interventional Pulmonology, Getwell Hospital and Research Institute, Nagpur, Maharashtra, India

Correspondence Address:
Sheetu Singh
167 Officers' Campus Extension, Sirsi Road, Jaipur - 302 012, Rajasthan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/lungindia.lungindia_414_20

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Background: Predictors of survival for interstitial lung disease (ILD) in the Indian population have not been studied. The primary objective of the study was to assess the Modified-Gender Age and Physiology (M-GAP) score to predict survival in patients with ILD seen in clinical practice. We also analyzed the role of demographic and radiological characteristics in predicting the survival of patients with ILD. Materials and Methods: In the ILD India registry, data were collected from 27 centers across 19 cities in India between March 2012 and June 2015. A single follow-up was conducted at 18 centers who agreed to participate in the follow-up in 2017. M-GAP score (range 0–5) was calculated with the following variables: age (≤60 years 0, 61–65 years 1, and >65 years 2), gender (female 0, male 1), and forced vital capacity% (>75% 0, 50%–75% 1, and >75% 2). A score of 0–3 and score of 4 and 5 were classified into Stage 1 and 2, respectively. Other predictors of survival, such as the history of tuberculosis, smoking, and the presence of honeycombing on computed tomography scan, were also evaluated. Results: Nine hundred and seven patients were contacted in 2017. Among them, 309 patients were lost to follow-up; 399 were alive and 199 had died. M-GAP was significantly associated with survival. Similarly, other predictors of survival were ability to perform spirometry (hazard ratio [HR]: 0.49, 95% confidence interval [CI]: 0.34–0.72), past history of tuberculosis (HR: 1.57, 95% CI: 1.07–2.29), current or past history of smoking (HR: 1.51, 95% CI: 1.06–2.16), honeycombing (HR: 1.81, 95% CI: 1.29–2.55), a diagnosis of connective tissue disease -ILD (HR: 0.41, 95% CI: 0.22–0.76), and sarcoidosis (HR: 0.24, 95% CI: 0.08–0.77). Conclusion: In a subgroup of patients with newly diagnosed ILD enrolled in ILD India registry and who were available for follow-up, M-GAP score predicted survival. Honeycombing at the time of diagnosis, along with accurate history of smoking, and previous history of tuberculosis were useful indices for predicting survival.

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