GAP in IPF

 Q: 64 years old male who has never had access to any healthcare, admitted to ICU with severe hypoxemia. Subsequent workup led to diagnosis of idiopathic lung fibrosis (IPF). Pulmonology service starts to calculate the GAP model.  The GAP stands for? (select one)

A) Gene-Age-Physiology model 

B) Gender-Age-Physiology model

C) Graded-Age-Physiology model

D) Guided-Age-Physiology model

E) Goal-directed-Age-Physiology model

Answer: B

GAP is a validated clinical prediction model for patients with IPF to predict 1, 2, and 3-year mortality. The calculator takes into account - gender, age, predicted Forced Vital Capacity (FVC) and predicted diffusing capacity of the lungs for carbon monoxide (DLCO). Once combined with functional status, patient wishes, and other clinical conditions it helps to decide on the aggressiveness of treatment ranging from lung transplant to palliation.

The calculator is simple to use and can be viewed at  https://www.acponline.org/journals/annals/extras/gap/

# pulmonary

#transplantations

References:

1. Ley B, Ryerson CJ, Vittinghoff E, Ryu JH, Tomassetti S, Lee JS, Poletti V, Buccioli M, Elicker BM, Jones KD, King TE Jr, Collard HR. A multidimensional index and staging system for idiopathic pulmonary fibrosis. Ann Intern Med. 2012 May 15;156(10):684-91. doi: 10.7326/0003-4819-156-10-201205150-00004. PMID: 22586007.

2. Lee SH, Kim SY, Kim DS, Kim YW, Chung MP, Uh ST, Park CS, Jeong SH, Park YB, Lee HL, Shin JW, Lee EJ, Lee JH, Jegal Y, Lee HK, Kim YH, Song JW, Park SW, Park MS. Predicting survival of patients with idiopathic pulmonary fibrosis using GAP score: a nationwide cohort study. Respir Res. 2016 Oct 18;17(1):131. doi: 10.1186/s12931-016-0454-0. PMID: 27756398; PMCID: PMC5069824.