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Patients with sarcoidosis and drug toxicity\u2013related ILD were excluded. MLN diameter and location were assessed. Plasma cytokine levels were analyzed in a subset of patients. The primary outcome was transplant-free survival (TFS). Secondary outcomes included all-cause and respiratory hospitalizations, lung function, and plasma cytokine concentrations. Cox regression was used to assess mortality risk. Outcomes were assessed in three independent ILD cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Chest CT scans were assessed in 1,094 patients (mean age, 64 yr; 52% male). MLN enlargement (\u226510 mm) was present in 66% (n\u2009=\u2009726) and strongly predicted TFS (hazard ratio [HR], 1.53; 95% confidence interval [CI], 1.12\u20132.10; P\u2009=\u20090.008) and risk of all-cause and respiratory hospitalizations (internal rate of return [IRR], 1.52; 95% CI, 1.17\u20131.98; P\u2009=\u20090.002; and IRR, 1.71; 95% CI, 1.15\u20132.53; P\u2009=\u20090.008, respectively) when compared with subjects with MLN &amp;lt;10 mm. Patients with MLN enlargement had lower lung function and decreased plasma concentrations of soluble CD40L (376 pg\/ml vs. 505 pg\/ml, P\u2009=\u20090.001) compared with those without MLN enlargement. Plasma IL-10 concentration &amp;gt;45 pg\/ml predicted mortality (HR, 4.21; 95% CI, 1.21\u201314.68; P\u2009=\u20090.024). Independent analysis of external datasets confirmed these findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MLN enlargement predicts TFS and hospitalization risk in ILD and is associated with decreased levels of a key circulating cytokine, soluble CD40L. Incorporating MLN and cytokine findings into current prediction models might improve ILD prognostication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201804-0761oc","type":"journal-article","created":{"date-parts":[[2018,9,15]],"date-time":"2018-09-15T19:52:48Z","timestamp":1537041168000},"page":"747-759","source":"Crossref","is-referenced-by-count":44,"title":["Prognosticating Outcomes in Interstitial Lung Disease by Mediastinal Lymph Node Assessment. An Observational Cohort Study with Independent Validation"],"prefix":"10.1093","volume":"199","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7015-9610","authenticated-orcid":false,"given":"Ayodeji","family":"Adegunsoye","sequence":"first","affiliation":[{"name":"Section of Pulmonary and Critical Care, Department of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin M.","family":"Oldham","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of California at Davis, Davis, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Bonham","sequence":"additional","affiliation":[{"name":"Section of Pulmonary and Critical Care, Department of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara","family":"Hrusch","sequence":"additional","affiliation":[{"name":"Section of Pulmonary and Critical Care, Department 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