Early decrease in erector spinae muscle area and future risk of mortality in idiopathic pulmonary fibrosis

概要

Assessment of the cross-sectional area of the erector spinae muscles (ESMCSA) by computed tomography (CT) can be used to evaluate sarcopenia and cachexia in patients with lung diseases. The aim of this study was to confirm whether serial changes in ESMCSA are associated with survival in patients with idiopathic pulmonary fibrosis (IPF). Data from consecutive patients with IPF who were referred to a single centre were retrospectively reviewed. We measured the ESMCSA at the level of the 12th thoracic vertebra on CT images at referral and 6 months later (n=119). The follow-up time was from 817−1633 days (median, 1335 days) and 59 patients (49.6%) died. A univariate Cox regression analysis showed that the decline in % predicted forced vital capacity (FVC) (Hazard ratios [HR] 1.041, 95% confidence interval [CI] 1.013–1.069, P = 0.004), the decline in body mass index (BMI) (HR 1.084, 95% CI 1.037–1.128; P < 0.001) and that in ESMCSA (HR 1.057, 95% CI 1.027–1.086; P < 0.001) were prognostic factors. For multivariate analyses, the decline in ESMCSA (HR 1.039, 95% CI 1.007– 1.071, P =0.015) was a significant prognostic factor, while those in % FVC and BMI were discarded. Serial changes in ESMCSA might be a useful predictor of the prognosis patients with IPF.