RT Journal Article
SR Electronic
T1 Impact of computed tomographic patterns and extent on clinical management and outcomes of patients with organizing pneumonia
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00505-2022
DO 10.1183/23120541.00505-2022
A1 Tang-Hsiu Huang
A1 Sheng-Huan Wei
A1 Li-Ting Huang
A1 Hong-Ping Er
A1 Yu-Ting Yu
A1 Chung-Ta Lee
A1 Yau-Lin Tseng
A1 Chao-Liang Wu
YR 2022
UL http://openres.ersjournals.com/content/early/2022/11/10/23120541.00505-2022.abstract
AB Background Organizing pneumonia (OP) has variable clinical and radiographic presentations and unstandardized treatments. Most patients with OP have favourable outcomes, but some develop respiratory insufficiency, experience recurrence, or die. In this study we investigated the impact of computed tomographic (CT) patterns and extent of OP on the diagnostic and therapeutic management that patients received, and that on the therapeutic response and prognosis (particularly the risk of respiratory insufficiency and death).Methods We retrospectively studied 156 patients with OP followed at our hospital between 2010 and 2021. The diagnosis was confirmed histologically and verified by multidisciplinary specialists. We performed Firth's logistic regression to determine the relationship between CT features and aetiologies, management, and outcomes including the risk of severe disease (defined as the need of supplemental oxygen or mechanical ventilation). We conducted Kaplan-Meier analyses to assess survival differences.Results Patients exhibiting multi-lobe involvement or mixed patterns, or both, were more likely to have secondary OP and receive immunosuppressants. Higher proportions of these patients experienced recurrence. Compared to patients with single-lobe involvement and single-pattern, they also had an enhanced risk of severe disease (the adjusted odds ratio for patients who simultaneously had multi-lobe involvement and mixed patterns was 27.64; 95% confidence interval, 8.25–127.44). Besides, these patients had decreased survival probabilities.Conclusion Different CT features of OP impact patients’ management and prognosis. When treating patients with OP exhibiting multi-lobe involvement or mixed patterns, or both, it is important to identify the possible causative aetiology and follow closely for adverse outcomes.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: The authors have nothing to disclose.