Newly defined acute exacerbation of idiopathic pulmonary fibrosis with surgically-proven usual interstitial pneumonia: risk factors and outcome.


Journal

Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG
ISSN: 2532-179X
Titre abrégé: Sarcoidosis Vasc Diffuse Lung Dis
Pays: Italy
ID NLM: 9610928

Informations de publication

Date de publication:
2019
Historique:
received: 21 02 2018
accepted: 19 09 2018
entrez: 2 6 2020
pubmed: 1 1 2019
medline: 1 7 2020
Statut: ppublish

Résumé

In 2016, the diagnostic criteria for the acute exacerbation (AE) of idiopathic pulmonary fibrosis (IPF) were revised. However, there have been published few clinical reports on AE-IPF published using the new criteria. The aim of this study was to investigate the incidence of, risk factors for, and mortality due to newly defined AE. Moreover, differences between triggered AE and idiopathic AE were investigated. The retrospective study was conducted including all IPF patients diagnosed with surgically-proven usual interstitial pneumonia through multi-disciplinary discussion between January 2006 and December 2015. Data were retrieved from a clinical chart review. A total of 107 patients with newly diagnosed 107 IPF patients were included. The cumulative incidence of initial AE were 9.6% at 1 year, 16.8% at 2 years, 23.9% at 3 years, and 37.3% at 4 years after diagnosis. Three risk factors for AE-IPF development were identified: 1) the minimum peripheral ozygen saturation level of ≤88% during the 6-minute walk test at the time of diagnosis; 2) forced vital capacity (FVC) decreasing by ≥10% in 1 year; and 3) diffusion capacity of the lungs for carbon monoxide (DLco) decreasing by ≥15% in 1 year. There were no significant differences in background (excluding C-reactive protein), survival and treatment between patients with triggered AE and those with idiopathic AE. The 6-minute walk test and an annual decline in FVC and DLco were predictive factors for AE incidence. The causes of AE-IPF did not affect the prognosis or treatment options in clinical practice.

Sections du résumé

BACKGROUND BACKGROUND
In 2016, the diagnostic criteria for the acute exacerbation (AE) of idiopathic pulmonary fibrosis (IPF) were revised. However, there have been published few clinical reports on AE-IPF published using the new criteria. The aim of this study was to investigate the incidence of, risk factors for, and mortality due to newly defined AE. Moreover, differences between triggered AE and idiopathic AE were investigated.
METHODS METHODS
The retrospective study was conducted including all IPF patients diagnosed with surgically-proven usual interstitial pneumonia through multi-disciplinary discussion between January 2006 and December 2015. Data were retrieved from a clinical chart review.
RESULTS RESULTS
A total of 107 patients with newly diagnosed 107 IPF patients were included. The cumulative incidence of initial AE were 9.6% at 1 year, 16.8% at 2 years, 23.9% at 3 years, and 37.3% at 4 years after diagnosis. Three risk factors for AE-IPF development were identified: 1) the minimum peripheral ozygen saturation level of ≤88% during the 6-minute walk test at the time of diagnosis; 2) forced vital capacity (FVC) decreasing by ≥10% in 1 year; and 3) diffusion capacity of the lungs for carbon monoxide (DLco) decreasing by ≥15% in 1 year. There were no significant differences in background (excluding C-reactive protein), survival and treatment between patients with triggered AE and those with idiopathic AE.
CONCLUSIONS CONCLUSIONS
The 6-minute walk test and an annual decline in FVC and DLco were predictive factors for AE incidence. The causes of AE-IPF did not affect the prognosis or treatment options in clinical practice.

Identifiants

pubmed: 32476935
doi: 10.36141/svdld.v36i1.7117
pii: SVDLD-36-39
pmc: PMC7247113
doi:

Types de publication

Journal Article

Langues

eng

Pagination

39-46

Informations de copyright

Copyright: © 2019.

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Auteurs

Ryo Okuda (R)

Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center.

Eri Hagiwara (E)

Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center.

Takuma Katano (T)

Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center.

Satoshi Ikeda (S)

Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center.

Akimasa Sekine (A)

Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center.

Hideya Kitamura (H)

Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center.

Tomohisa Baba (T)

Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center.

Koji Okudela (K)

Department of Pathology, Yokohama City University Graduate School of Medicine.

Kenichi Ohashi (K)

Department of Pathology, Yokohama City University Graduate School of Medicine.

Takashi Ogura (T)

Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center.

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Classifications MeSH