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2018 ; 57
(5
): 655-661
Nephropedia Template TP
gab.com Text
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English Wikipedia
Prognostic Factors in the Acute Exacerbation of Idiopathic Pulmonary Fibrosis: A
Retrospective Single-center Study
#MMPMID29151518
Atsumi K
; Saito Y
; Kuse N
; Kobayashi K
; Tanaka T
; Kashiwada T
; Inomata M
; Kokuho N
; Hayashi H
; Kamio K
; Fujita K
; Abe S
; Azuma A
; Kubota K
; Gemma A
Intern Med
2018[Mar]; 57
(5
): 655-661
PMID29151518
show ga
Objectives Acute exacerbation of idiopathic pulmonary fibrosis (IPF-AE) has been
recognized as a fatal pulmonary disorder, but the exact prognostic factors are
unknown. The aim of the present study was to analyze the clinical characteristics
of patients with IPF-AE and identify the prognostic factors. Methods The medical
records of 59 cases of IPF-AE were retrospectively reviewed. Clinical data,
laboratory data, radiographic findings, treatment, and time from the onset of
symptoms to the initiation of corticosteroid pulse therapy, i.e. symptom
duration, and outcome were analyzed. Results The IPF Stage, Gender-Age-Physiology
(GAP) Index, symptom duration, and the high-resolution computed tomography (HRCT)
score were significantly related to the prognosis in the univariate analysis. In
the multivariate analysis, the symptom duration remained a significant prognostic
factor (hazard ratio of 1-day increase, 1.11; 95% confidence interval, 1.01-1.15;
p=0.0427). The area under the receiver operating characteristics curve of symptom
duration was statistically significant for survivors versus non-survivors (area
under the curve, 0.73; p=0.012). The survival period was significantly shorter in
the late-treatment groups (?5 days; n=30) than in the early-treatment groups (<5
days; n=29; log-rank test; p<0.0001). Conclusion The time interval between the
onset of symptoms and the initiation of corticosteroid pulse therapy may be an
independent prognostic factor in patients with IPF-AE.
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