Risk factors for an acute exacerbation of idiopathic pulmonary fibrosis View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-07-11

AUTHORS

Tomoyuki Kakugawa, Noriho Sakamoto, Shuntaro Sato, Hirokazu Yura, Tatsuhiko Harada, Shota Nakashima, Atsuko Hara, Keishi Oda, Hiroshi Ishimoto, Kazuhiro Yatera, Yuji Ishimatsu, Yasushi Obase, Shigeru Kohno, Hiroshi Mukae

ABSTRACT

BackgroundAcute exacerbations of idiopathic pulmonary fibrosis are major causes of morbidity and mortality among patients with idiopathic pulmonary fibrosis. However, acute exacerbations remain unpredictable. The aim of this study was to investigate risk factors for acute exacerbations of idiopathic pulmonary fibrosis.MethodsWe performed a retrospective cohort study of patients with idiopathic pulmonary fibrosis who visited our institutions from January 1999 to September 2014. We investigated risk factors for acute exacerbations in patients with idiopathic pulmonary fibrosis diagnosed retrospectively based on the official 2011 idiopathic pulmonary fibrosis ATS/ERS/JRS/ALAT Update Statement.ResultsThe idiopathic pulmonary fibrosis study cohort included 65 subjects. The median follow-up period was 2.6 years. During follow-up, 24 patients (36.9 %) experienced acute exacerbations. A Kaplan-Meier curve demonstrated that the 1-year, 2-year, and 3-year incidences of acute exacerbation were 9.6, 19.2 and 31.0 %, respectively. Acute exacerbation exerted a significant impact on overall survival among those with the disease. A log-rank test showed that baseline cardiovascular diseases, higher GAP (gender, age, physiology) stage (≥II), higher serum lactate dehydrogenase level (≥180 U/L), higher serum surfactant protein-D level (≥194.7 ng/mL), higher neutrophil (≥1.77 %) and eosinophil (≥3.21 %) percentages in bronchoalveolar lavage fluid samples, and treatment with an immunosuppressive agent after diagnosis were associated with poor acute exacerbation-free probability. In the Cox analysis adjusted for treatment with an immunosuppressive agent, baseline cardiovascular diseases, higher GAP stage (≥II), and higher eosinophil percentage (≥3.21 %) in bronchoalveolar lavage fluid samples were predictors of an acute exacerbation of idiopathic pulmonary fibrosis.ConclusionsThis study demonstrated that baseline cardiovascular diseases, higher GAP stage (≥II), and higher eosinophil percentage (≥3.21 %) in bronchoalveolar lavage fluid samples were associated with the onset of an acute exacerbation of idiopathic pulmonary fibrosis. More... »

PAGES

79

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12931-016-0400-1

DOI

http://dx.doi.org/10.1186/s12931-016-0400-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1016854797

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27401332


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31 schema:description BackgroundAcute exacerbations of idiopathic pulmonary fibrosis are major causes of morbidity and mortality among patients with idiopathic pulmonary fibrosis. However, acute exacerbations remain unpredictable. The aim of this study was to investigate risk factors for acute exacerbations of idiopathic pulmonary fibrosis.MethodsWe performed a retrospective cohort study of patients with idiopathic pulmonary fibrosis who visited our institutions from January 1999 to September 2014. We investigated risk factors for acute exacerbations in patients with idiopathic pulmonary fibrosis diagnosed retrospectively based on the official 2011 idiopathic pulmonary fibrosis ATS/ERS/JRS/ALAT Update Statement.ResultsThe idiopathic pulmonary fibrosis study cohort included 65 subjects. The median follow-up period was 2.6 years. During follow-up, 24 patients (36.9 %) experienced acute exacerbations. A Kaplan-Meier curve demonstrated that the 1-year, 2-year, and 3-year incidences of acute exacerbation were 9.6, 19.2 and 31.0 %, respectively. Acute exacerbation exerted a significant impact on overall survival among those with the disease. A log-rank test showed that baseline cardiovascular diseases, higher GAP (gender, age, physiology) stage (≥II), higher serum lactate dehydrogenase level (≥180 U/L), higher serum surfactant protein-D level (≥194.7 ng/mL), higher neutrophil (≥1.77 %) and eosinophil (≥3.21 %) percentages in bronchoalveolar lavage fluid samples, and treatment with an immunosuppressive agent after diagnosis were associated with poor acute exacerbation-free probability. In the Cox analysis adjusted for treatment with an immunosuppressive agent, baseline cardiovascular diseases, higher GAP stage (≥II), and higher eosinophil percentage (≥3.21 %) in bronchoalveolar lavage fluid samples were predictors of an acute exacerbation of idiopathic pulmonary fibrosis.ConclusionsThis study demonstrated that baseline cardiovascular diseases, higher GAP stage (≥II), and higher eosinophil percentage (≥3.21 %) in bronchoalveolar lavage fluid samples were associated with the onset of an acute exacerbation of idiopathic pulmonary fibrosis.
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38 ConclusionsThis study
39 Cox analysis
40 GAP stage
41 Kaplan-Meier curves
42 MethodsWe
43 acute exacerbation
44 agents
45 aim
46 analysis
47 baseline cardiovascular disease
48 bronchoalveolar lavage fluid samples
49 cardiovascular disease
50 cause
51 cohort
52 cohort study
53 curves
54 dehydrogenase levels
55 diagnosis
56 disease
57 eosinophil percentage
58 exacerbation
59 factors
60 fibrosis
61 fluid samples
62 follow
63 high neutrophil
64 high serum
65 high serum lactate dehydrogenase level
66 higher eosinophil percentage
67 idiopathic pulmonary fibrosis
68 immunosuppressive agents
69 impact
70 incidence
71 institutions
72 lactate dehydrogenase levels
73 lavage fluid samples
74 levels
75 log-rank test
76 major cause
77 median follow
78 morbidity
79 mortality
80 neutrophils
81 onset
82 overall survival
83 patients
84 percentage
85 period
86 predictors
87 probability
88 pulmonary fibrosis
89 retrospective cohort study
90 risk factors
91 samples
92 serum
93 serum lactate dehydrogenase level
94 significant impact
95 stage
96 statements
97 study
98 study cohort
99 subjects
100 survival
101 test
102 treatment
103 update statements
104 years
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