The prognostic value of erythrocyte sedimentation rate in all-cause mortality of patients with idiopathic pulmonary fibrosis: Based on inpatient hospital records
Aiyuan Zhou, Qing Song, Dingding Deng, Xiyan Zhang, Pinhua PanBackground
Idiopathic pulmonary fibrosis (IPF) is a chronic progressive interstitial lung disease with a high mortality rate. Reliable biomarker can enable clinicians to judge the development and prognosis of IPF.
Objectives
This study aimed to investigate the prognostic value of erythrocyte sedimentation rate (ESR) for predicting all-cause mortality in IPF.
Design
This retrospective cohort study enrolled patients hospitalized with IPF between January 1st, 2015 and May 31st, 2023.
Methods
Data was collected regarding patient demographics, laboratory analysis results, and the following pulmonary function parameters: the forced expiratory volume in one second percentage of predicted (FEV1 %pred), forced vital capacity percentage of predicted (FVC %pred), diffusing capacity divided by the alveolar volume (DLCO/VA), DLCO, DLCO %pred. All-cause mortality data were collected throughout the 18 months follow-up period.
Results
A total of 510 IPF patients recruited for the final analysis, 131 (25.7%) died during follow-up. IPF patients who died were older, had a higher white blood cell, lactic dehydrogenase, fibrinogen and ESR. In addition, IPF patients who died had a worse pulmonary function, as evidenced by lower FEV1 %pred, FVC %pred, DLCO %pred and DLCO/VA (P<0.05). Logistic regression analysis showed that ESR was an independent risk factor for IPF patients who died, with OR=1.024, 95% CI=1.002-1.048 (P<0.05). Based on the receiver operating characteristic curve, ESR could predict all-cause mortality in IPF patients, with an area under the curve of 0.645 and a 95% CI of 0.591-0.700 (P<0.05). The optimal ESR cut-off value was determined to be 21.5 mm/h. Cox regression analysis revealed that IPF patients with an ESR ≥ 21.5 mm/h had a significantly higher all-cause mortality risk, with a hazard ratio of 5.406 and a 95% CI of 1.177-24.825 (P<0.05).
Conclusion
ESR is a promising biomarker for predicting all-cause mortality in IPF patients.