%0 Journal Article %A Akihiko Sokai %A Kiminobu Tanizawa %A Tomohiro Handa %A Takeshi Kubo %A Seishu Hashimoto %A Kohei Ikezoe %A Yoshinari Nakatsuka %A Kensaku Aihara %A Yoshio Taguchi %A Shigeo Muro %A Toru Oga %A Sonoko Nagai %A Takateru Izumi %A Toyohiro Hirai %A Kazuo Chin %A Michiaki Mishima %T Asymmetry in acute exacerbation of idiopathic pulmonary fibrosis %D 2017 %R 10.1183/23120541.00036-2016 %J ERJ Open Research %P 00036-2016 %V 3 %N 2 %X Acute exacerbation (AE) of idiopathic pulmonary fibrosis (IPF) results in poor survival. The objective of the present study was to elucidate the impact of asymmetrical ground-glass opacity (GGO) and/or consolidation on outcomes in patients with AE-IPF.The cases of 59 consecutive patients with AE-IPF were retrospectively reviewed. High-resolution computed tomography (HRCT) at diagnosis of an AE was assessed to determine the disease extent and asymmetry. Asymmetrical AE was defined as a right-to-left ratio of GGO and consolidation ≥2.0 or ≤0.5. The impacts of HRCT indices and other clinical parameters on 180-day mortality were analysed.The overall 180-day mortality rate was 59.2%, and asymmetrical AE was observed in 13 patients (22.0%). A multivariate analysis revealed that asymmetrical AE was a significant predictor of 180-day mortality (hazard ratio=0.36, p=0.047), long-term oxygen therapy before AE and serum lactate dehydrogenase levels. The 180-day mortality of patients with asymmetrical AE was significantly lower than that of patients with symmetrical AE (asymmetrical AE 30.8% versus symmetrical AE 68.2%, p=0.03).An asymmetrical distribution of GGO and/or consolidation is a predictor of survival in patients with AE-IPF.Asymmetrical distribution of GGOs and consolidation could indicate better survival in acute exacerbation of IPF http://ow.ly/EaEr307VTRN %U https://openres.ersjournals.com/content/erjor/3/2/00036-2016.full.pdf