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2.2.11.1 Clinical Predictors
Age:
A clinical component of IPF is older age with a median age of 66 years during the
period of diagnosis (NCBI, 2000; Raghu et al., 2006b). Older age additionally has been
exhibited to bestow a poorer prognosis. It was exhibited in one study that a Hazard Ratio (HR)
of 0.25 (Confidence Interval [CI], 0.125–0.5) for survival in patients younger than 50 years of
age (Erbes et al., 1997). Median survival in another study for patients younger than 50 years
of age was 116.4 months in contrast with 62.8 months for subjects aged 50–60 years, 27.2
months for subjects 60 to 70 years of age and 14.6 months for subjects older than 70 years of
age (King et al., 2001b). A descriptive study of patients with IPF younger than 50 years of
age although witnessed a median survival of only 2.1 years, in contrast to that witnessed in
older patients with IPF (Nadrous et al., 2005). It was proposed by the authors of this study
that earlier findings of younger age as a beneficial prognostic component may have been
because of the inclusion of patients with nonspecific interstitial pneumonia in the previous
studies and/or distinctions in the definition of disease onset. It was demonstrated currently by
Fell and colleagues that age, in coalesces with the observations on HRCT is a significant
diagnostic tool that recognizes patients with IPF (Fell et al., 2010). Emanating data
additionally proposes that age-associated modifications in cellular activity may a play
significant role in the pathogenesis of IPF (Collard, 2010).
Sex:
It is observed that IPF is more common in men, but sex distinctions in survival have
been variable (Schwartz et al., 1994; King et al., 2001b; Erbes et al., 1997). According to a
study that basically evaluated sex distinctions in IPF the female sex observed to bestow a
remarkable survival benefit (HR, 0.63; CI, 0.41–0.97) after assimilating for age, smoking
level and baseline physiologic variables (Han et al., 2008). This survival benefit prevailed
remarkable even after modifying for 6-month alterations in 6-minute walk test (6MWT)
desaturation and FVC % anticipated, proposing the survival benefit may not be completely
described by distinctions in disease advancement. Mortality rates in women with pulmonary
fibrosis although are rising more quickly as compared to men (Olson et al., 2007).
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