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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

Impact of acute exacerbation on overall survival. There was a significant difference in survival between patients who experienced an acute exacerbation (median survival time, 2.8 years) and those who did not (median survival time, not calculable) (log-rank test, P < 0.001)
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Fig2: Impact of acute exacerbation on overall survival. There was a significant difference in survival between patients who experienced an acute exacerbation (median survival time, 2.8 years) and those who did not (median survival time, not calculable) (log-rank test, P < 0.001)

Mentions: AE exerted a significant impact on overall survival in IPF. There was a significant difference in survival between patients who experienced an AE (MST, 2.8 years) and those who did not (MST, not calculable) (log-rank test, P < 0.001) (Fig. 2).Fig. 2


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)

Impact of acute exacerbation on overall survival. There was a significant difference in survival between patients who experienced an acute exacerbation (median survival time, 2.8 years) and those who did not (median survival time, not calculable) (log-rank test, P < 0.001)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: Impact of acute exacerbation on overall survival. There was a significant difference in survival between patients who experienced an acute exacerbation (median survival time, 2.8 years) and those who did not (median survival time, not calculable) (log-rank test, P < 0.001)
Mentions: AE exerted a significant impact on overall survival in IPF. There was a significant difference in survival between patients who experienced an AE (MST, 2.8 years) and those who did not (MST, not calculable) (log-rank test, P < 0.001) (Fig. 2).Fig. 2

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