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- Title
Clinical Features and Outcome of Acute Exacerbation of Interstitial Pneumonia: Collagen Vascular Diseases-Related versus Idiopathic.
- Authors
Tachikawa, Ryo; Tomii, Keisuke; Ueda, Hiroyuki; Nagata, Kazuma; Nanjo, Shigeki; Sakurai, Ayako; Otsuka, Kyoko; Kaji, Reiko; Hayashi, Michio; Katakami, Nobuyuki; Imai, Yukihiro
- Abstract
Background: Relatively little is known about acute exacerbation (AE) of interstitial pneumonia associated with collagen vascular diseases (CVD-IPs). Objectives: This study was aimed at clarifying clinical characteristics and outcome in AE of CVD-IPs, compared with those of idiopathic interstitial pneumonias (IIPs). Methods: We retrospectively reviewed 112 admission cases with suspected AE of CVD-IPs or IIPs during 2003-2009. IIPs were diagnosed with idiopathic pulmonary fibrosis (IPF) or non-IPF, mostly based on radiologic findings. Of these, 15 AEs of CVD-IPs (6 rheumatoid arthritis, 6 dermatomyositis and 3 systemic sclerosis) and 47 AEs of IIPs (13 IPF and 34 non-IPF) were included. Results: The clinical characteristics in AE of CVD-IPs were similar to those of IIPs, except for younger age (63.3 ± 6.8 vs. 73.8 ± 9.1 years; p = 0.0001) and higher PaO2/FiO2 at the onset of AE (205 ± 81.2 vs. 145 ± 53.8 mm Hg; p = 0.002) in the former. Dermatomyositis-related interstitial pneumonia (IP) showed a relatively indolent onset and was often associated with worsening control of the underlying disease, whereas AE of other CVD-IPs resembled that of IIPs. 90-day mortality of 33% in AE of CVD-IPs was similar to that of IIPs (44%; p = 0.44) or non-IPF (34%; p = 0.94), but was significantly better than that of IPF (69%; p = 0.04). Conclusion: Clinical features and outcome in AE of CVD-IPs were similar, if not identical, to those of IIPs, having a significant impact on the clinical course. AE of advanced IPF with typical radiologic features seems to have higher mortality compared with other forms of IP. Copyright © 2011 S. Karger AG, Basel
- Subjects
JAPAN; HORMONE therapy; ACTIVE oxygen in the body; ADRENOCORTICAL hormones; AGE distribution; ARTIFICIAL respiration; VASCULAR diseases; CHI-squared test; COLLAGEN diseases; DERMATOMYOSITIS; EXANTHEMA; FISHER exact test; HOSPITALS; INTERSTITIAL lung diseases; DEATH rate; MULTIVARIATE analysis; HEALTH outcome assessment; REGRESSION analysis; SURVIVAL analysis (Biometry); T-test (Statistics); TREATMENT effectiveness; PROPORTIONAL hazards models; RETROSPECTIVE studies; DISEASE exacerbation; DATA analysis software; IDIOPATHIC interstitial pneumonias; IDIOPATHIC pulmonary fibrosis; DESCRIPTIVE statistics; KAPLAN-Meier estimator; THERAPEUTICS
- Publication
Respiration, 2012, Vol 83, Issue 1, p20
- ISSN
0025-7931
- Publication type
Article
- DOI
10.1159/000329893