Acute exacerbation admissions of fibrosing interstitial lung diseases – 3 years study

Abstract

Introduction: Acute exacerbations (AE) are frequent in patients with fibrosing interstitial lung diseases (F-ILD) with usual interstitial pneumonia (UIP) pattern. AE are defined as a significant respiratory deterioration, less than 1-month duration, with new radiological abnormalities and associated with worse outcome. Aims: To study the etiology and outcomes of patients admitted with AE of F-ILD. Methods: Retrospective study of patients admitted with AE of F-ILD from January 2015 to August 2018. F-ILD due to pneumoconiosis and tuberculosis were excluded. Results: 115 admissions were identified, corresponding to 47 patients, median age 77±8 years and 61.7% males. Main diagnoses were F-ILD secondary to chronic hypersensitivity pneumonitis (CHP, 68.7%), connective tissue diseases (CTD, 11.3%), idiopathic pulmonary fibrosis (IPF, 9.6%) and drugs (3.5%). 8 inpatients had other F-ILD with UIP pattern. AE main cause was infection (75.7%). Hospitalization median duration was 9±6 days. 48.7% of cases occurred in Winter. Median time to new admission was 45±145 days. Each patient had a median of 2 admissions, statistically related with previous respiratory failure (RF) (p Conclusion: F-ILD implies high risk of respiratory acute event, mostly by infections. Previous RF were largely present, indicative of advanced disease and probability of more AE. Need for NIV meant poor prognosis. As in international studies, mortality was high among F-ILD due to IPF.