In-hospital Mortality Associated with Granulomatosis with Polyangiitis and Microscopic Polyangiitis Complicated with Respiratory Failure

Francisco F Costa Filho; Vanita Motiani; Alan Furlan; Austin Brubaker; Pranav Kidambi; Philip Kroth

doi:10.36141/svdld.2026.18438

Authors

Francisco F Costa Filho Corewell Health West
Vanita Motiani Western Michigan University Homer Stryker MD School of Medicine
Alan Furlan Western Michigan University Homer Stryker MD School of Medicine
Austin Brubaker Western Michigan University Homer Stryker MD School of Medicine
Pranav Kidambi Corewell Health West
Philip Kroth Western Michigan University Homer Stryker MD School of Medicine

Keywords:

ANCA-associated Vasculitis, Granulomatosis with polyangiitis, Microscopic polyangiitis, National Inpatient Sample database, Respiratory Failure

Abstract

Abstract.

Background and aim: Our study aimed to determine the in-hospital mortality rate among granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) hospitalizations complicated with acute respiratory failure (ARF) in the US and determine the independent predictors of in-hospital mortality.

Method

We performed a retrospective cohort analysis utilizing the National In-patient Sample (NIS) database to identify hospitalizations of patients with GPA or MPA associated with ARF from 2016 to 2021. The outcomes included in-hospital mortality, requirement of invasive procedures, and hospital length of stay. Univariable and multivariable analysis were used to identify independent predictors associated with in-hospital mortality.

Results

We identified 4,283 unweighted hospitalizations with diagnosis of GPA or MPA associated with ARF. 78.3% of those were diagnosed with GPA, 19.2% with MPA, and 2.5% with both ICD-10 codes. The mean age was 63.7 years, 53.6% were female, and 73.3% were White. The rate of hemodialysis was 21.5%, plasmapheresis 7.5%, and extracorporeal membrane oxygenation in 0.5% of hospitalizations. The overall in-hospital mortality was 15.4%, compared to 35.9% in the subgroup requiring IMV. Independent predictors associated with increased in-hospital mortality were higher age, acute kidney injury (AKI), sepsis, requirement of non-invasive mechanical ventilation, interstitial lung disease (ILD), history of stroke, shock, and requirement of IMV.

Conclusion

GPA or MPA hospitalizations complicated with ARF were found to be associated with a high in-hospital mortality rate. Higher age, AKI, sepsis, shock, history of ILD, history of stroke, and requirement of mechanical ventilation were found to be independent predictors associated with increased in-hospital mortality.

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