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Acute Exacerbation of Idiopathic Pulmonary Fibrosis Over a 9-Year Period in a Community Teaching Hospital in Japan
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A1664 - Acute Exacerbation of Idiopathic Pulmonary Fibrosis Over a 9-Year Period in a Community Teaching Hospital in Japan
Author Block: M. Yamazoe, H. Tomioka; Department of Respiratory Medicine, Kobe City Medical Center West Hospital, Kobe, Japan.
RATIONALE: Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is a major cause of morbidity and mortality in patients with IPF. An International Working Group proposed revised definition and diagnostic criteria for AE-IPF in 2016 (Am J Respir Crit Care Med 2016;194:265-75). Based on these criteria, AE-IPF can be diagnosed regardless of the presence or absence of a known trigger and further categorized as triggered AE-IPF or idiopathic AE-IPF, depending on whether an underlying trigger is found. However, the clinical characteristics and significance of the newly defined AE-IPF are not well known. SETTING: A 358-bed community teaching hospital in Japan. METHODS: We retrospectively analyzed the clinical and laboratory features of patients with AE-IPF admitted to our hospital over a 9-year period (from January 2008 to August 2017). RESULTS: During the study period AE-IPF was diagnosed in fifty-two cases. The number of the cases of AE-IPF showed a tendency to decrease after peaking in 2010; 6 in 2008, 7 in 2009, 12 in 2010, 6 in 2011, 4 in 2012, 3 in 2013, 3 in 2014, 3 in 2015, and 5 in 2016, and 3 in 2017. They consisted of 9 males (17.3%) and 43 females (82.7%) with a mean age of 75.5 years (range: 60-95 years). They were categorized as 32 (61.5%) idiopathic and 20 (38.5%) triggered. Underlying triggers were drugs (n=7), infections (n=5), drug and infections (n=1), surgeries or examinations (n=5), and others (n=2). Sixteen patients had a lung cancer and 15 of them were categorized as the triggered group. Twenty-six patients (50%) died in-hospital. The chi-square test showed no significant difference in-hospital mortalities between idiopathic group and triggered group (46.9% vs 55.0%, P = 0.57). The medium number of days in our hospital was 25.5 days. Survival after admission due to AE-IPF was 67.3% at day 30, 41.5% at 6 months, and 30.3% at 1 year with a median survival of 104 days. CONCLUSIONS: The number of AE-IPF cases admitted to our hospital had a tendency to decrease after peaking in 2010. Lung cancer complicated with IPF was one of the risk factors of the triggers AE-IPF. The idiopathic group and the triggered group did not show significant difference in-hospital mortality.
Author Block: M. Yamazoe, H. Tomioka; Department of Respiratory Medicine, Kobe City Medical Center West Hospital, Kobe, Japan.
RATIONALE: Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is a major cause of morbidity and mortality in patients with IPF. An International Working Group proposed revised definition and diagnostic criteria for AE-IPF in 2016 (Am J Respir Crit Care Med 2016;194:265-75). Based on these criteria, AE-IPF can be diagnosed regardless of the presence or absence of a known trigger and further categorized as triggered AE-IPF or idiopathic AE-IPF, depending on whether an underlying trigger is found. However, the clinical characteristics and significance of the newly defined AE-IPF are not well known. SETTING: A 358-bed community teaching hospital in Japan. METHODS: We retrospectively analyzed the clinical and laboratory features of patients with AE-IPF admitted to our hospital over a 9-year period (from January 2008 to August 2017). RESULTS: During the study period AE-IPF was diagnosed in fifty-two cases. The number of the cases of AE-IPF showed a tendency to decrease after peaking in 2010; 6 in 2008, 7 in 2009, 12 in 2010, 6 in 2011, 4 in 2012, 3 in 2013, 3 in 2014, 3 in 2015, and 5 in 2016, and 3 in 2017. They consisted of 9 males (17.3%) and 43 females (82.7%) with a mean age of 75.5 years (range: 60-95 years). They were categorized as 32 (61.5%) idiopathic and 20 (38.5%) triggered. Underlying triggers were drugs (n=7), infections (n=5), drug and infections (n=1), surgeries or examinations (n=5), and others (n=2). Sixteen patients had a lung cancer and 15 of them were categorized as the triggered group. Twenty-six patients (50%) died in-hospital. The chi-square test showed no significant difference in-hospital mortalities between idiopathic group and triggered group (46.9% vs 55.0%, P = 0.57). The medium number of days in our hospital was 25.5 days. Survival after admission due to AE-IPF was 67.3% at day 30, 41.5% at 6 months, and 30.3% at 1 year with a median survival of 104 days. CONCLUSIONS: The number of AE-IPF cases admitted to our hospital had a tendency to decrease after peaking in 2010. Lung cancer complicated with IPF was one of the risk factors of the triggers AE-IPF. The idiopathic group and the triggered group did not show significant difference in-hospital mortality.
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