Interstitial lung disease: retrospective study of the prognostic impact of acute exacerbations

Interstitial lung disease: retrospective study of the prognostic impact of acute exacerbations

Authors

Keywords:

interstitial lung disease; pulmonary fibrosis; acute exacerbation

Abstract

Background: Interstitial lung diseases have high mortality associated with hospitalization for decompensation. There are doubts about the factors involved in the progression of fibrosis, for example the role played by acute exacerbations.  With this work, the authors intend to analyze whether there are predictive parameters of mortality related to exacerbations.

Methods: A retrospective study was carried out of patients admitted to the Pulmonology department of Coimbra University Hospital Center for exacerbation of fibrosing lung disease between January 2019 and December 2020. These were classified as: idiopathic pulmonary fibrosis (IPF), fibrosing hypersensivity pneumonitis (FHP) and other fibrosing lung diseases. Statistical analysis was performed using SPSS 26.0 considering statistically significant p<0.05 values.

Results: The results show that IPF is associated with longer hospital stay in relation to fibrosing HP and other fibrosing lung diseases mean of 20.93 days (95% CI: 14.69-27.18) vs 11.8 days (95% CI: 1.05-17.22, p=0.023) vs 12.23 days (95% CI 2.06-15.34, p=0.007), respectively. Regarding mortality, there was no difference between IPF, PH and other fibrosing diseases (p=0.631).

Conclusion: This study demonstrated that IPF, compared to PH and other fibrosing diseases, is associated with longer hospital stays, probably due to its progressive course despite the institution of corticosteroid therapy. As shown in previous studies, it was concluded that there is no difference in terms of mortality between IPF exacerbations and other forms of fibrosing lung disease.

References

Antoniou KM, Margaritopoulos GA, Tomassetti S, Bonella F, Costabel U, Poletti V. Interstitial lung disease. Eur Respir Rev. 2014 Mar 1;23(131):40-54. doi: 10.1183/09059180.00009113. PMID: 24591661.

Azadeh N, Moua T, Baqir M, Ryu JH. Treatment of acute exacerbations of interstitial lung disease. Expert Rev Respir Med. 2018;12(4):325-327. doi:10.1080/17476348.2018.1446831

Collard HR, Moore BB, Flaherty KR, et al. Acute exacerbations of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2007 Oct 1;176(7):636-43. doi: 10.1164/rccm.200703-463PP.

Cuerpo S, Moisés J, Hernández-González F, et al. Acute exacerbations of idiopathic pulmonary fibrosis: Does clinical stratification or steroid treatment matter? Chron Respir Dis. 2019 Jan-Dec; 16:1479973119869334. doi: 10.1177/1479973119869334.

Salonen J, Jansa S, Vähänikkilä H, Kaarteenaho R. Re-hospitalisation predicts poor prognosis after acute exacerbation of interstitial lung disease. BMC Pulm Med. 2023 Jul 1;23(1):236. doi: 10.1186/s12890-023-02534-0.

Kershaw CD, Batra K, Torrealba JR, Terada LS. Characteristics and evaluation of acute exacerbations in chronic interstitial lung diseases. Respir Med. 2021 Jul;183:106400. doi: 10.1016/j.rmed.2021.106400. Epub 2021 Apr 26.

Ba C, Wang H, Jiang C, Shi X, Jin J, Fang Q. Clinical manifestations and prognostic factors analysis of patients hospitalised with acute exacerbation of idiopathic pulmonary fibrosis and other interstitial lung diseases. BMJ Open Respir Res. 2024 Feb 27;11(1):e001997. doi: 10.1136/bmjresp-2023-001997.

Faverio P, Stainer A, Conti S, et al. Differences between Acute Exacerbations of Idiopathic Pulmonary Fibrosis and Other Interstitial Lung Diseases. Diagnostics (Basel). 2021 Sep 6;11(9):1623. doi: 10.3390/diagnostics11091623.

Spagnolo P, Wuyts W. Acute exacerbations of interstitial lung disease: lessons from idiopathic pulmonary fibrosis. Curr Opin Pulm Med. 2017 Sep;23(5):411-417. doi: 10.1097/MCP.0000000000000405.

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Published

10-12-2024

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Section

Original Articles: Clinical Research

How to Cite

1.
Pacheco J, Santos AI, Catarata MJ, Freitas S. Interstitial lung disease: retrospective study of the prognostic impact of acute exacerbations . Sarcoidosis Vasc Diffuse Lung Dis [Internet]. 2024 Dec. 10 [cited 2025 Mar. 13];41(4):e2024051. Available from: https://mail.mattioli1885journals.com/index.php/sarcoidosis/article/view/15198