title: Self-Report Daily Life Activity as a Prognostic Marker of Idiopathic Pulmonary Fibrosis.
abstract: BACKGROUND
  Idiopathic pulmonary fibrosis (IPF) is a progressive disease, leading to substantial physical impairment. The distance walked in 6 min (6MWD) is a measure of exercise tolerance and is of prognostic relevance in IPF. While 6MWD is a punctual measurement which may not be representative, self-reported daily life activity may represent the patients' functional capacity more globally even in less severe affected patients.
  
  
  OBJECTIVE
  We evaluated and characterized a simple classification system based on the patients' self-reported daily activity and analyzed if this would add significantly to the prognostic information of the 6MWD alone in IPF patients.
  
  
  METHODS
  Daily life activity was assessed in IPF (n = 156) patients with standardized questions and categorized in activity classes (AC I-IV), comprising the less severe impaired in AC I and II. The 6MWD was also assessed.
  
  
  RESULTS
  ACs were related to the lung functional impairment and inversely correlated to the 6MWD. Thirty-two patients were in AC I/II, 98 in AC III and 26 patients in AC IV. Thirty-seven (23.7%) patients died during a median follow-up of 14.9 months, comprising 1 patient in AC I/II. In addition, a 6MWD <470 m predicted mortality. Combining AC I/II and a 6MWD >470 m identified a subgroup of patients with favorable outcome.
  
  
  CONCLUSIONS
  AC is a novel scoring system which can easily be obtained and correlates with lung functional and physical impairments as well as mortality. Moreover, AC adds prognostic information to the 6MWD.
authors.affiliation: Department of Internal Medicine V, Asklepios Fachkliniken München-Gauting, Comprehensive Pneumology Center, Ludwig Maximilians University, Klinikum Grosshadern, Munich, Germany.
authors.forename: Hanno H
authors.initials: HH
authors.lastname: Leuchte
authors.forename: Philip
authors.initials: P
authors.lastname: Mernitz
authors.forename: Carlos
authors.initials: C
authors.lastname: Baezner
authors.forename: Rainer A
authors.initials: RA
authors.lastname: Baumgartner
authors.forename: Werner
authors.initials: W
authors.lastname: von Wulffen
authors.forename: Claus
authors.initials: C
authors.lastname: Neurohr
authors.forename: Juergen
authors.initials: J
authors.lastname: Behr
mesh_terms: D000203:Activities of Daily Living; D018450:Disease Progression; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000145:classification* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012129:Respiratory Function Tests; D057566:Self Report; D012720:Severity of Illness Index