The following is a summary of “ILD-GAP combined with the monocyte ratio could be a better prognostic prediction model than ILD-GAP in patients with interstitial lung diseases,” published in the January 2024 issue of Pulmonology by Hirata et al.

The ILD-GAP scoring system has proven valuable in prognosticating outcomes for patients with interstitial lung disease (ILD). Elevated monocyte counts have been linked to a heightened risk of poor prognosis in idiopathic pulmonary fibrosis (IPF). 

This study investigated whether augmenting the ILD-GAP scoring system with the monocyte ratio (ILD-GAPM) improves prognostic accuracy compared to the conventional ILD-GAP model.

Our retrospective analysis encompassed patients treated with ILD between April 2013 and April 2017. We scrutinized baseline clinical parameters, including age, sex, Charlson Comorbidity Index score (CCIS), ILD diagnosis, blood biomarkers, pulmonary function test results, and disease outcomes. The ILD cohort comprised patients diagnosed with IPF, idiopathic nonspecific interstitial pneumonia (iNSIP), collagen vascular disease-related interstitial pneumonia (CVD-IP), chronic hypersensitivity pneumonitis (CHP), and unclassifiable ILD (UC-ILD). Prognostic predictive abilities were compared between the ILD-GAP and ILD-GAPM models.

Our analysis included 179 patients, with a mean age of 73 years, all of whom underwent pulmonary function testing, including the percentage predicted diffusion capacity for carbon monoxide. Among them, 56 cases were diagnosed with IPF, 112 with iNSIP and CVD-IP, 6 with CHP, and 5 with UC-ILD. The ILD-GAPM model exhibited a larger area under the receiver-operating characteristic curve (0.747) than the ILD-GAP (0.710) for predicting 3-year ILD-related events. Additionally, the log-rank test revealed that Kaplan-Meier curves in ILD-GAPM significantly differed by stage (P = 0.015), whereas no significant difference was observed by stage in ILD-GAP (P = 0.074).

In conclusion, the ILD-GAPM model emerges as a more precise prognostic tool for patients with ILD than the conventional ILD-GAP model.

Source: bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-023-02833-6