Abstract
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.
Abstract
Asymmetrical distribution of GGOs and consolidation could indicate better survival in acute exacerbation of IPF http://ow.ly/EaEr307VTRN
Footnotes
Support statement: The present study was supported in part by a grant from Japan's Ministry of Health, Labor, and Welfare to the Diffuse Lung Diseases Research Group, the Respiratory Failure Study Group, and the Research Program of Intractable Disease. Other support included a KAKENHI Grant-in-Aid for Young Scientists (B) awarded by the Japan Society for the Promotion of Science and grants from the Japan Intractable Diseases Research Foundation. Funding information for this article has been deposited with the Crossref Funder Registry.
Conflict of interest: Disclosures can be found alongside this article at openres.ersjournals.com
- Received March 11, 2016.
- Accepted December 17, 2016.
- Copyright ©ERS 2017
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