Retrospective evaluation of the factors affecting survival inpatients diagnosed as 'idiopathic interstitial pneumonia' between january 01, 2015 and january 01, 2021, in the chest diseases outpatient clinic of Akdeniz University Hospital

Abstract Retrospective Evaluation of the Factors Affecting Survival in Patients Diagnosed as 'Idiopathic Interstitial Pneumonia' between January 01, 2015 and January 01, 2021, in the Chest Diseases Outpatient Clinic of Akdeniz University Hospital Objective: The aim of our study is investigate the demographic characteristics (age, gender), smoking characteristics, occupational and environmental exposures, comorbidities, respiratory symptoms, spirometric pulmonary function tests, carbon monoxide diffusion tests, 6-minute walk distance tests, medications used in the treatment of IIP and the relationships between 1, 3, and 5 year survival in patients diagnosed with IIP in the Chest Diseases Outpatient Clinic of Akdeniz University Hospital between January 01, 2015 and January 01, 2021. Materials and Methods: Patients were included in the study over the age of 18 who were diagnosed with IIP between 01 January 2015 and 01 January 2021 in Akdeniz University Hospital Chest Diseases Outpatient Clinic. Patients under the age of 18 and diagnosed with lung cancer were not included in the study. Although histopathological sampling was recommended, patients who did not accept sampling or did not have long-term follow-up after the diagnosis of IIP were not included in the study. Results: A total of 342 patients diagnosed with IIP were included in our study. The mean age of the patients was 65.4 ± 11.3, and the median was 66 (min=26 – max=92). 156 (45.6%) patients were below 65 years of age (<65 years) and 186 (54.4%) patients were 65 years or older. There was no significant difference between the mean age of male and female patients (p>0.05). 19.8% (n=68) of patients were NSIP, 57.4% (n=197) IPF, 3.5% (n=12) RB-ILD, 5% (n=17) DIP, 7.6% (n=26) COP, 3.8% (n=13) LIP, 0.6% (n=2) PPFE, and 2.3% (n) =8) belonged to the unclassified group. It was found that 28.9% (n=99) of the patients were non-smokers, 60.6% (n=208) quit smoking and 10.2% (n=35) were still smoking individuals. Considering the respiratory symptoms of the patients at the time of admission; 77.8% (n=266) had dyspnea, 76.6% (n=262) cough, 8.8% (n=30) chest pain, 18.1% (n=62) sputum and 0.9% (n=3) had hemoptysis complaints. In pulmonary function tests, FVC (LT) level was 2.42 ± 0.82, mean % FVC ratio was 71.2% ± 17.7%, mean FEV1 (LT) level was 2.19 ± 0.73, mean FEV1/FVC ratio was 90 .1 ± 7.19, % DLCO mean 59.98 ± 19.1%, DLCO/VA mean 89.81 ± 21.85, Six Minute Walk Test (6DYT) distance findings mean 323.59 ± 117, Rest mean values were 94.89 ± 3.63, mean SpO2 values after 6DYT were 91.39 ± 5.18. The number of patients with exertional desaturation was 197 (57.4%), and the number of patients without desaturation was 119 (34.7%). Mortality rates of the patients were found to be 61.1% (n=209) alive and 38.9% (n=133) deceased. Considering the general survival analysis of the patients; It was determined that 1-year survival was 90.9%, 3-year survival was 73.5%, and 5-year survival was 52.7%. It was determined that the mean survival time of patients under 65 years of age was 50.55 ± 1.33 months, and the mean survival time of patients aged 65 and over was 44.47 ± 1.48 months. When the survival rates of the patients were compared according to their smoking history, 1, 3, and 5-year survival rates were observed while 85.9%, 65.6%, and 44.1%, respectively, in patients who had never smoked, 91.8%, 74.1% and 53.3% in patients who had quit smoking, and 97% in patients who were active smokers. ,1, 91.4%, and 70%. Considering the survival rates of the patients according to the diagnosis method, 1, 3, and 5-year survival rates were determined while 89.6%, 68.8%, and 46.9% in those diagnosed by radiological method, 93%, 80.5%, and 60.8% in patients diagnosed by histological method, respectively. While the mean survival time was 49.26 ± 1.03 (47.26 – 51.27) months in patients with FVC (%) value above 50%, it was 31.58 ± 3.47 (24.78) months in patients with 50% or less – 38.39) months. It was determined 51.96 ± 0.99 (50.02 – 53.90) months in patients with a DLCO value above 40%, and 35.39 ± 3.35 (28.83 – 41.95) months in patients with a DLCO value of 40% or less. While it was 52.26 ± 1.07 (50.17 – 54.35) months in patients with a 6MWT distance greater than 250 m, it was 40.44 ± 2.52 (35.5 – 45.39) months in patients with a distance of 250 m or less. ) was found to be the month. Mean survival times were 55.36 ± 1.13 (53.14 – 57.56) months in non-desaturated patients and 42.75 ± 1.44 (39.93 – 45.57) months in desaturated patients. Mean survival times were 53.47 ± 1.07 (51.37 – 55.58) months in patients with SpO2 levels above 90%, 41.8 ± 2.09 (37.70 – 55.58) months in patients with SpO2 levels above 90% 45.90) months. Conclusion: IIP is a disease with high mortality, which significantly affects lung functions. Early diagnosis and treatment may lead to factors such as reduced progression, increased treatment response, reduced complications, and prolongation of life expectancy. It is thought that the results to be obtained from more comprehensive studies and new treatment plans will have an impact on survival. Keywords: Idiopathic Interstitial Pneumonias, Diffuse Parenchymal Lung Diseases