The GAP index and staging system for idiopathic pulmonary fibrosis

	Predictor		Points
G	Gender
	Female		0
	Male		1
A	Age (years)
	≤60		0
	61 to 65		1
	>65		2
P	Physiology
	FVC (% predicted)
	>75		0
	50 to 75		1
	<50		2
	DLCO (% predicted)
	>55		0
	36 to 55		1
	≤35		2
	Cannot perform		3
Total possible points			8
Stage	I	II	III
Points	0 to 3	4 to 5	6 to 8
Mortality
1-year	5.6	16.2	39.2
2-years	10.9	29.9	62.1
3-years	16.3	42.1	76.8

Points are assigned for each variable of the scoring system to obtain a total point score (range 0 to 8). Patients should be scored in the "cannot perform" category for DLCO if their symptoms or lung function prohibited performance of the DLCO maneuver. If DLCO is unavailable because it was not ordered or not completed because of nonrespiratory limitations, then the model cannot be applied. The total point score is used to classify patients as stage I (0 to 3 points), stage II (4 to 5 points), or stage III (6 to 8 points). Model-predicted one-, two-, and three-year mortality is shown by stage.

GAP: gender, age, and two lung physiology variables (FVC and DLCO); FVC: forced vital capacity; DLCO: diffusing capacity for carbon monoxide.

From Annals of Internal Medicine, Ley B, Ryerson CJ, Vittinghoff E, et al. A multidimensional index and staging system for idiopathic pulmonary fibrosis. Ann Intern Med 2012; 156(10):684-91. Copyright © 2012 American College of Physicians. All Rights Reserved. Reprinted with the permission of American College of Physicians, Inc.

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The GAP index and staging system for idiopathic pulmonary fibrosis