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Risk factors for an acute exacerbation of idiopathic pulmonary fibrosis.

Kakugawa T, Sakamoto N, Sato S, Yura H, Harada T, Nakashima S, Hara A, Oda K, Ishimoto H, Yatera K, Ishimatsu Y, Obase Y, Kohno S, Mukae H - Respir. Res. (2016)

Bottom Line: 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.This 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. kakugawa@nagasaki-u.ac.jp.

ABSTRACT

Background: Acute 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.

Methods: We 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.

Results: The 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.

Conclusions: This 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.

No MeSH data available.


Related in: MedlinePlus

Incidence of acute exacerbation of idiopathic pulmonary fibrosis. The Kaplan-Meier curve demonstrates that the 1-year, 2-year, and 3-year incidences of AE-IPF were 9.6, 19.2 and 31.0 %, respectively
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Fig1: Incidence of acute exacerbation of idiopathic pulmonary fibrosis. The Kaplan-Meier curve demonstrates that the 1-year, 2-year, and 3-year incidences of AE-IPF were 9.6, 19.2 and 31.0 %, respectively

Mentions: During the follow-up period, 24 patients (36.9 %) experienced AEs. Eighteen patients (27.7 %) were lost to follow-up. The Kaplan-Meier curve demonstrated that the 1-year, 2-year, and 3-year incidences of AE-IPF were 9.6, 19.2 and 31.0 %, respectively (Fig. 1).Fig. 1


Risk factors for an acute exacerbation of idiopathic pulmonary fibrosis.

Kakugawa T, Sakamoto N, Sato S, Yura H, Harada T, Nakashima S, Hara A, Oda K, Ishimoto H, Yatera K, Ishimatsu Y, Obase Y, Kohno S, Mukae H - Respir. Res. (2016)

Incidence of acute exacerbation of idiopathic pulmonary fibrosis. The Kaplan-Meier curve demonstrates that the 1-year, 2-year, and 3-year incidences of AE-IPF were 9.6, 19.2 and 31.0 %, respectively
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940941&req=5

Fig1: Incidence of acute exacerbation of idiopathic pulmonary fibrosis. The Kaplan-Meier curve demonstrates that the 1-year, 2-year, and 3-year incidences of AE-IPF were 9.6, 19.2 and 31.0 %, respectively
Mentions: During the follow-up period, 24 patients (36.9 %) experienced AEs. Eighteen patients (27.7 %) were lost to follow-up. The Kaplan-Meier curve demonstrated that the 1-year, 2-year, and 3-year incidences of AE-IPF were 9.6, 19.2 and 31.0 %, respectively (Fig. 1).Fig. 1

Bottom Line: 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.This 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. kakugawa@nagasaki-u.ac.jp.

ABSTRACT

Background: Acute 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.

Methods: We 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.

Results: The 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.

Conclusions: This 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.

No MeSH data available.


Related in: MedlinePlus