Evaluation of the palliative criteria in idiopathic pulmonary fibrosis

Introduction: Consensed and objective criteria to identify IPF patients with palliative needs are mising. The Danish Respiratory Society(DRS) recently published some recommendations. Objective: Assess the usefulness of DRS palliative criteria in a cohort of IPF patients. Methodology: Retrospective descriptive study of patients with IPF attended at hospital ILD unit and diagnosed since 2012. Sociodemographic, functional data, hospital admission, and the DRS criteria were assessed. Results: In a cohort of 68 patients diagnosed with IPF,25(37.3%)died during the follow-up. Patient characteristics at diagnosis and palliative criteria results are summarized in figure1. Using DRS criteria we would have identified 20 patients(80%) of the deceased. Sensitivity(S), specificity (Sp), positive predictive value(PPV), negative predictive value(NPV) and accuracy index ( AI) were 0,80; 0,88; 0,80 ;0,88 and respectively. Adding DLCO less than 35% of reference or inability to perform it, in the lung function section of the previous criteria, the S,Sp, PPV, NPV, AI increased to 0,96;0,88;0,97; 0,92; 0,91 respectively and we identified 24 patients(96%) in palliative status. Conclusions: The SDR palliative criteria would have identified 80% of our patients with IPF as palliative. Adding DLCO value to previous criteria the S, E, AI increased. The proposed new criteria would have identified 96% of patients one year before death.