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Acute exacerbation of idiopathic pulmonary fibrosis: a 10-year single-centre retrospective study
INTRODUCTION: In 2016, an international working group proposed a revised definition and new diagnostic criteria for the acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF). Based on these criteria, AE-IPF was diagnosed regardless of the presence or absence of a known trigger and categorised...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203000/ https://www.ncbi.nlm.nih.gov/pubmed/30397488 http://dx.doi.org/10.1136/bmjresp-2018-000342 |
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author | Yamazoe, Masatoshi Tomioka, Hiromi |
author_facet | Yamazoe, Masatoshi Tomioka, Hiromi |
author_sort | Yamazoe, Masatoshi |
collection | PubMed |
description | INTRODUCTION: In 2016, an international working group proposed a revised definition and new diagnostic criteria for the acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF). Based on these criteria, AE-IPF was diagnosed regardless of the presence or absence of a known trigger and categorised as triggered (T-AE) or idiopathic (I-AE) AE-IPF. However, the clinical characteristics of the newly defined AE-IPF and clinical differences between T-AE and I-AE are unresolved. METHODS: We retrospectively analysed 64 patients with AE-IPF (I-AE (42), T-AE (22)) admitted to our hospital over a 10- year period. RESULTS: I-AE and T-AE cases did not show differences in in-hospital and long-term outcomes (in-hospital mortality: I-AE 52.4%, T-AE 59.1%, p=0.61; long-term mortality: p=0.68). In the I-AE group, significantly more patients received corticosteroid therapy before an AE (I-AE 35.7%, T-AE 4.5%; p=0.01). Significantly more patients in the T-AE group had lung cancer (I-AE 7.1%, T-AE 59.1%, p<0.001). I-AE occurred more frequently in winter while T-AE did not show seasonality. The white blood cell (WBC) count and haemoglobin (Hb) level were independent predictors of in-hospital deaths in I-AE (WBC: OR 1.87; 95% CI 1.09 to 4.95, p=0.01; Hb: OR 0.26, 95% CI 0.04 to 0.78, p=0.01) but not T-AE. DISCUSSION: With the introduction of new criteria for AE-IPF, a retrospective study over a 10-year period showed a lack of prognostic difference between I-AE and T-AE. The WBC count and Hb level predicted in-hospital outcome in I-AE cases. |
format | Online Article Text |
id | pubmed-6203000 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-62030002018-11-05 Acute exacerbation of idiopathic pulmonary fibrosis: a 10-year single-centre retrospective study Yamazoe, Masatoshi Tomioka, Hiromi BMJ Open Respir Res Interstitial Lung Disease INTRODUCTION: In 2016, an international working group proposed a revised definition and new diagnostic criteria for the acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF). Based on these criteria, AE-IPF was diagnosed regardless of the presence or absence of a known trigger and categorised as triggered (T-AE) or idiopathic (I-AE) AE-IPF. However, the clinical characteristics of the newly defined AE-IPF and clinical differences between T-AE and I-AE are unresolved. METHODS: We retrospectively analysed 64 patients with AE-IPF (I-AE (42), T-AE (22)) admitted to our hospital over a 10- year period. RESULTS: I-AE and T-AE cases did not show differences in in-hospital and long-term outcomes (in-hospital mortality: I-AE 52.4%, T-AE 59.1%, p=0.61; long-term mortality: p=0.68). In the I-AE group, significantly more patients received corticosteroid therapy before an AE (I-AE 35.7%, T-AE 4.5%; p=0.01). Significantly more patients in the T-AE group had lung cancer (I-AE 7.1%, T-AE 59.1%, p<0.001). I-AE occurred more frequently in winter while T-AE did not show seasonality. The white blood cell (WBC) count and haemoglobin (Hb) level were independent predictors of in-hospital deaths in I-AE (WBC: OR 1.87; 95% CI 1.09 to 4.95, p=0.01; Hb: OR 0.26, 95% CI 0.04 to 0.78, p=0.01) but not T-AE. DISCUSSION: With the introduction of new criteria for AE-IPF, a retrospective study over a 10-year period showed a lack of prognostic difference between I-AE and T-AE. The WBC count and Hb level predicted in-hospital outcome in I-AE cases. BMJ Publishing Group 2018-10-09 /pmc/articles/PMC6203000/ /pubmed/30397488 http://dx.doi.org/10.1136/bmjresp-2018-000342 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Interstitial Lung Disease Yamazoe, Masatoshi Tomioka, Hiromi Acute exacerbation of idiopathic pulmonary fibrosis: a 10-year single-centre retrospective study |
title | Acute exacerbation of idiopathic pulmonary fibrosis: a 10-year single-centre retrospective study |
title_full | Acute exacerbation of idiopathic pulmonary fibrosis: a 10-year single-centre retrospective study |
title_fullStr | Acute exacerbation of idiopathic pulmonary fibrosis: a 10-year single-centre retrospective study |
title_full_unstemmed | Acute exacerbation of idiopathic pulmonary fibrosis: a 10-year single-centre retrospective study |
title_short | Acute exacerbation of idiopathic pulmonary fibrosis: a 10-year single-centre retrospective study |
title_sort | acute exacerbation of idiopathic pulmonary fibrosis: a 10-year single-centre retrospective study |
topic | Interstitial Lung Disease |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203000/ https://www.ncbi.nlm.nih.gov/pubmed/30397488 http://dx.doi.org/10.1136/bmjresp-2018-000342 |
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