Malnutrition in idiopathic pulmonary fibrosis: the great forgotten comorbidity!

The publication by Torrisi et al . [1] in the European Respiratory Journal evaluated the ability of comorbidities to improve the prediction of survival of idiopathic pulmonary fibrosis (IPF) patients. These variables are in addition to those in the best validated Gender-Age-Physiology (GAP) multivariable prediction model for mortality in IPF. The authors have added to the four parameters (age, sex, forced vital capacity per cent predicted and diffusing capacity of the lung for carbon monoxide per cent predicted) of the GAP model [2] comorbidities such as gastro-oesophageal reflux, pulmonary hypertension, lung cancer, valvular heart disease and atrial arrhythmias, which were found to have a significant impact on survival. They showed that the inclusion of comorbidities in TORVAN models significantly improved the prediction of the risk of death. BMI/nutritional assessment should be part of the evaluation of IPF patients, since it has an impact on prognosis