Association of the lung immune prognostic index with the survival of patients with idiopathic interstitial pneumonias

Respirology. 2024 Feb;29(2):136-145. doi: 10.1111/resp.14621. Epub 2023 Nov 3.

Abstract

Background and objective: The lung immune prognostic index (LIPI), a simple index calculated from the blood lactate dehydrogenase level and derived neutrophil-to-lymphocyte ratio, is thought to be associated with host immune status. However, the utility of LIPI in patients with idiopathic interstitial pneumonias (IIPs) is unknown.

Methods: In this multicentre, retrospective, observational study, an association between LIPI and the survival of patients with IIPs was evaluated.

Results: Exploratory and validation cohorts consisting of 460 and 414 patients with IIPs, respectively, were included (159 and 159 patients had idiopathic pulmonary fibrosis [IPF], and 301 and 255 had non-IPF, respectively). In the exploratory cohort, patients with IPF and a low LIPI had significantly better survival than those with a high LIPI (median of 5.6 years vs. 3.9 years, p = 0.016). The predictive ability of LIPI for the survival of patients with IPF was validated in the validation cohort (median of 8.5 years vs. 4.4 years, p = 0.003). In a multivariate Cox proportional hazard analysis, LIPI was selected as an independent predictive factor for the survival of IPF patients. There was no significant association between LIPI and survival of non-IPF patients in the exploratory and validation cohorts.

Conclusion: The LIPI was a predictive factor for the survival of patients with IPF and could aid the management of IPF.

Keywords: idiopathic interstitial pneumonia; idiopathic pulmonary fibrosis; interstitial lung disease; lactate dehydrogenase; neutrophil-to-lymphocyte ratio.

Publication types

  • Observational Study
  • Multicenter Study

MeSH terms

  • Humans
  • Idiopathic Interstitial Pneumonias*
  • Idiopathic Pulmonary Fibrosis*
  • Lung
  • Prognosis
  • Retrospective Studies