GAP Index for Idiopathic Pulmonary Fibrosis
Gender, Age, Physiology (GAP) index predicts 1, 2, and 3-year mortality in idiopathic pulmonary fibrosis (IPF) using clinical and physiological variables.
Score interpretation
GAP Stage I — 1-year mortality ~6%, 3-year mortality ~16%
→ Initiate antifibrotic therapy (nintedanib or pirfenidone); monitor FVC every 3–6 months; O₂ assessment; pulmonary rehab
GAP Stage II — 1-year mortality ~16%, 3-year mortality ~43%
→ Antifibrotic therapy; lung transplant evaluation; palliative care discussion; early enrolment in trials
GAP Stage III — 1-year mortality ~39%, 3-year mortality ~77%
→ Urgent transplant evaluation; palliative care; symptom management (cough, dyspnoea, anxiety); advance care planning
Interpretation bands for the GAP Index. Apply clinical judgement and local guidance.
References
- Ley B et al. A multidimensional index and staging system for idiopathic pulmonary fibrosis. Ann Intern Med. 2012;156(10):684–691.
Related
Curated clinical cross-links plus same-class fallbacks.
- Nitric Oxide (Inhaled — iNO) · Selective Pulmonary Vasodilator
- Selexipag · Pulmonary Arterial Hypertension
- Macitentan · Pulmonary Arterial Hypertension
- Methotrexate (Dermatology — Psoriasis) · Disease-Modifying Antirheumatic / Immunosuppressant
- Acetazolamide (Ménière's Disease) · Carbonic Anhydrase Inhibitor (Diuretic)
- Zinc acetate · Zinc salt (Wilson's disease)
- Acute Asthma in Adults · BTS/SIGN British Guideline on Asthma 2019; NICE NG80
- Pulmonary Embolism Assessment · NICE NG158; ESC 2019 PE Guidelines
- Acute Exacerbation of COPD (AECOPD) · NICE NG115; GOLD 2024
- Spontaneous Pneumothorax (Adult) · BTS Pleural Disease 2023
- Atypical Pneumonia (Legionella / Mycoplasma / Chlamydophila) · BTS 2023; IDSA
- COPD Exacerbation Management · NICE NG115 / GOLD 2024
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.