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1000 Titel
  • Prognostic differences among patients with idiopathic interstitial pneumonias with acute exacerbation of varying pathogenesis: a retrospective study
1000 Autor/in
  1. Kato, Motoyasu |
  2. Yamada, Tomoko |
  3. Kataoka, Shunichi |
  4. Arai, Yuta |
  5. Miura, Keita |
  6. Ochi, Yusuke |
  7. Ihara, Hiroaki |
  8. Koyama, Ryo |
  9. Sasaki, Shinichi |
  10. Takahashi, Kazuhisa |
1000 Erscheinungsjahr 2019
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2019-12-18
1000 Erschienen in
1000 Quellenangabe
  • 20:287
1000 Copyrightjahr
  • 2019
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1186/s12931-019-1247-z |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6921398/ |
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1000 Sprache der Publikation
1000 Abstract/Summary
  • BACKGROUND: Acute exacerbation of chronic fibrosing idiopathic interstitial pneumonias (AE-IIPs) is associated with a high mortality rate. In 2016, an international working group proposed a revised diagnostic criteria for AE-IIPs, suggesting that it be classified as idiopathic or triggered. Many factors are known to trigger AE-IIPs, including surgery, infection, and drugs. However, it is unknown which AE-IIPs triggers have a worse prognosis. We aimed to investigate the prognosis of patients with various clinical types of AE-IIPs, particularly infection-triggered, non-infection triggered, and idiopathic AE-IIPs. METHODS: We retrospectively collected data from 128 chronic fibrosing IIPs (CF-IIPs) patients who were hospitalized by respiratory failure between April 2009 and March 2019 at Juntendo University Hospital. Among these patients, we evaluated 79 patients who developed AE-IIPs and 21 who developed pneumonia superimposed on CF-IIPs. Patients with AE-IIPs were classified into three types: idiopathic, infection-triggered, and non-infection-triggered AE-IIPs. We analyzed differences in patient characteristics, examination findings; level of serum markers, results of pulmonary function, and radiological findings, prior treatment for baseline CF-IIPs, and prognosis. We then evaluated the risk factor for early death (death within 30 days from the onset of AE-IIPs) associated with AE-IIPs. RESULTS: Among the patients who developed AE-IIPs, 34 were characterized as having idiopathic, 25 were characterized as having infection-triggered, and 20 were categorized as having non-infection-triggered AE-IIPs. Survival time for pneumonia superimposed on IIPs was significantly longer than that for any AE-IIPs. Survival time for bacterial pneumonia superimposed on CF-IIPs was significantly longer than that for AE-IIPs (for each idiopathic and all triggered IIPs). Thereafter, survival time for infection-triggered was significantly longer than for idiopathic or non-infection-triggered AE-IIPs. The mortality rate was significantly lower in infection-triggered AE-IIPs than in other types of AE-IIPs. Furthermore, the incidence of infection-triggered AE-IIPs in winter was significantly higher than that in other seasons. Moreover, the clinical AE-IIPs types and radiological findings at AE-IIP onset were significant risk factors for AE-IIPs-induced early death. CONCLUSIONS: Our findings suggest that patients with infection-triggered AE-IIPs can expect a better prognosis than can patients with other clinical types of AE-IIPs.
1000 Sacherschließung
lokal Acute exacerbation
lokal Idiopathic pulmonary fibrosis
lokal Trigger
lokal Infection
lokal Idiopathic interstitial pneumonias
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1000 Liste der Beteiligten
  1. https://orcid.org/0000-0002-3217-5118|https://frl.publisso.de/adhoc/uri/WWFtYWRhLCBUb21va28=|https://frl.publisso.de/adhoc/uri/S2F0YW9rYSwgU2h1bmljaGk=|https://frl.publisso.de/adhoc/uri/QXJhaSwgWXV0YQ==|https://frl.publisso.de/adhoc/uri/TWl1cmEsIEtlaXRh|https://frl.publisso.de/adhoc/uri/T2NoaSwgWXVzdWtl|https://frl.publisso.de/adhoc/uri/SWhhcmEsIEhpcm9ha2k=|https://frl.publisso.de/adhoc/uri/S295YW1hLCBSeW8=|https://frl.publisso.de/adhoc/uri/U2FzYWtpLCBTaGluaWNoaQ==|https://frl.publisso.de/adhoc/uri/VGFrYWhhc2hpLCBLYXp1aGlzYQ==
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1000 Erstellt am 2020-11-18T13:27:03.243+0100
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