Abstract
To evaluate hospital mortality and associated risk factors for acute exacerbations of idiopathic pulmonary fibrosis (AEIPF). Emphases were put on incidence and impact of extra-pulmonary organ failures. Patients diagnosed with AEIPF from July 2014 to September 2018 were enrolled. Clinical data were collected. Acute physiology and chronic health evaluation II (APACHE II) and simplified acute physiological score II (SAPS II) were calculated. Extra-pulmonary organ failures were diagnosed upon criteria of sequential organ failure assessment (SOFA). Forty-five patients with AEIPF were included. Eighteen patients (40.0%) developed extra-pulmonary organ failures, and 25 patients (55.6%) died during hospitalization. Serum C-reactive protein (CRP) (p = 0.001), SAPS II (p = 0.004), SOFA (p = 0.001) were higher, whereas arterial oxygen pressure (PaO2)/ fractional inspired oxygen (FiO2) (p = 0.001) was lower in non-survivors than survivors. More non-survivors developed extra-pulmonary organ failures than survivors (p = 0.002). After adjustment, elevated serum CRP (OR 1.038, p = 0.049) and extra-pulmonary organ failure (OR 13.126, p = 0.016) were independent predictors of hospital mortality in AEIPF. AEIPF had high hospital mortality and occurrence of extra-pulmonary organ failure was common. Elevated serum CRP and extra-pulmonary organ failure had predictive values for mortality.
Highlights
To evaluate hospital mortality and associated risk factors for acute exacerbations of idiopathic pulmonary fibrosis (AEIPF)
There were 47 consecutive patients diagnosed with AEIPF in our center during the study period
After adjustment for age and gender, multivariate analysis revealed that an elevated serum C-reactive protein (CRP) and extra-pulmonary organ failure were independent risk factors for hospital mortality in patients with AEIPF (Table 2, Fig. 3 and Fig. 4)
Summary
To evaluate hospital mortality and associated risk factors for acute exacerbations of idiopathic pulmonary fibrosis (AEIPF). AEIPF had high hospital mortality and occurrence of extra-pulmonary organ failure was common. Few studies described the conditions of extra-pulmonary organs in patients with AEIPF We conducted this retrospective study in an interstitial lung disease center in China, to investigate the hospital mortality and associated risk factors of hospital mortality in patients with AEIPF. Acute physiology and chronic health evaluation II (APACHE II)[6], simplified acute physiological score II (SAPS II)[7] and sequential organ failure assessment (SOFA) s ystem[8] were used to evaluate the organ conditions and assess the incidence and impact of extra-pulmonary organ failures on hospital mortality in AEIPF
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