PT - JOURNAL ARTICLE AU - Tang-Hsiu Huang AU - Sheng-Huan Wei AU - Li-Ting Huang AU - Hong-Ping Er AU - Yu-Ting Yu AU - Chung-Ta Lee AU - Yau-Lin Tseng AU - Chao-Liang Wu TI - Impact of computed tomographic patterns and extent on clinical management and outcomes of patients with organising pneumonia AID - 10.1183/23120541.00505-2022 DP - 2023 Jan 01 TA - ERJ Open Research PG - 00505-2022 VI - 9 IP - 1 4099 - http://openres.ersjournals.com/content/9/1/00505-2022.short 4100 - http://openres.ersjournals.com/content/9/1/00505-2022.full SO - erjor2023 Jan 01; 9 AB - Background Organising pneumonia (OP) has variable clinical and radiographic presentations and unstandardised 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 for supplemental oxygen or mechanical ventilation). We conducted Kaplan–Meier analyses to assess survival differences.Results Patients exhibiting multilobe 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 multilobe 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 multilobe involvement or mixed patterns, or both, it is important to identify the possible causative aetiology and follow closely for adverse outcomes.Patients with organising pneumonia whose CT images exhibit multilobe involvement and mixed patterns have an increased risk of adverse outcomes https://bit.ly/3tjhYS8