Natural History and Prognosis of Advanced Lung Disease

Defining the natural history and prognosis of an illness is among the most important endeavors for physicians. Some medical specialties, particularly oncology, have at their disposal reliable formal staging systems to guide therapy and help patients make informed life decisions. Despite advances in diagnosis and therapy for pulmonary disorders, the ability to confidently predict the course of disease remains elusive for many of them. With the advent of newer treatment modalities such as volume reduction surgery for emphysema and lung transplantation, accurate prognostic indicators have become even more desirable. This article therefore reviews the literature regarding predicting prognosis for chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), primary pulmonary hypertension (PPH), cystic fibrosis (CF), sarcoidosis, asthma, lymphangioleiomyomatosis (LAM), and primary pulmonary histiocytosis X (PPHX).