• Tomoo Kishaba, Yousuke Shimaoka, Hajime Fukuyama, Hiroaki Nagano, Yuichiro Nei, Shin Yamashiro, and Hitoshi Tamaki.
• 1 Department of Respiratory Medicine, Okinawa Chubu Hospital, Uruma, Okinawa, Japan ; 2 Department of Respiratory Medicine, Nanbu Medical Center Naha, Okinawa, Japan ; 3 Department of Respiratory Medicine, Yaeyama Hospital, Ishigaki, Japan ; 4 Sunagawa Naika Clinic, Uruma, Okinawa, Japan.
• J Thorac Dis. 2015 May 1; 7 (5): 843-9.

BackgroundGender, age, and physiology (GAP) staging was recently advocated for idiopathic pulmonary fibrosis (IPF). However, clinical findings of GAP staging for IPF are limited. We aimed to investigate the clinical characteristics of IPF patients according to GAP staging in our hospital.MethodsWe retrospectively reviewed patient medical records and chest high-resolution computed tomography (HRCT) images from June 1, 2002, to December 31, 2012.ResultsWe identified 54 IPF patients with [36 men; mean age: 71 years (range, 53-85 years)]. Mean fibrosis and ground glass opacity (GGO) scores were 1.9 (0-4) and 1.6 (1-3.3), respectively. Mean percent predicted forced vital capacity (% FVC), percent predicted diffusing capacity of the lung for carbon monoxide (% DLco) were 70.6 (6.4-114.3), 49.2 (15-105.9), respectively. Cox proportional hazards model showed that gender, percent predicted diffusing capacity of the lung for carbon monoxide (% DLco), and composite physiologic index (CPI) were strong predictors of mortality. Stage III patients had more pulmonary hypertension (50% vs. 23%, 0%) and progressive modified Medical Research Council (mMRC) changes at 1 year (1.3 vs. 0.6, 1.1; P=0.07) compared with other stages.ConclusionsIn our cohort, GAP staging was useful for evaluating IPF severity. Stage III patients might had more pulmonary hypertension and progressive dyspnea. Multicenter analyses are warranted to confirm these findings.

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