Association of peripheral blood count values at diagnosis with disease severityand prognosis in patients with idiopathic pulmonary fibrosis

Objective: The aim of this study was to investigate the effect of peripheral blood count values at the time of diagnosis on disease severity and prognosis in patients with idiopathic pulmonary fibrosis (IPF). Material and Method: This retrospective cross-sectional study included patients diagnosed with IPF between January 1, 2017, and January 1, 2023.At the initial presentation, patients' demographic data, GAP score, spirometry values, high-resolution computed tomography pattern, and peripheral blood count values were recorded. Furthermore, hospitalizations due to acute exacerbations, and mortality information were retrospectively determined from patient files. Results: In our study, data from 100 IPF patients with a mean age of 67.2±8.9 years and 85% males were analyzed. During follow-up, 49.5% of the patients experienced exacerbations. The average number of hospitalizations was 0.9±1.6. Disease progression was observed in 41% of the patients, and 37% died during treatment. The mean survival time for patients who died was 677.8±488.8 days, and 70.3% of these patients died due to acute exacerbations. It was found that patients who died experienced more frequent exacerbations and hospitalizations (p=0.001). When laboratory parameters were compared according to mortality, it was observed that the white blood cell, neutrophil, and platelet counts at the time of diagnosis were higher in patients who died compared to survivors (p=0.005, p=0.001, and p=0.035, respectively). There was no statistically significant difference between the two groups in terms of monocyte, lymphocyte, erythrocyte distribution width, platelet distribution width, and hemoglobin values at the time of diagnosis. There was no significant correlation between monocyte elevation at diagnosis and prognosis and mortality (p=0.245 and p=0.205, respectively). There was no statistically significant correlation between monocyte elevation at diagnosis and GAP index (p=0.885). ROC analysis revealed that a white blood cell count of >9.1 103/µL could predict mortality with 62% sensitivity and 65% specificity, while an elevated neutrophil count could predict mortality with 65% sensitivity and 73% specificity. Conclusion: There is significant evidence suggesting that white blood cell and neutrophil levels may play a potentially important role in mortality prediction in IPF patients. In our study, no association was found between monocyte levels and mortality. However, further comprehensive studies are needed to investigate the relationship between monocyte counts and mortality. Key Words: Idiopathic Pulmonary Fibrosis, blood count values, mortality, prognosis