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Evaluation of incidental exacerbation of interstitial pneumonia in patients with non-respiratory diseases

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Hirotaka Matsuzaki1, Yu Mikami1, Naoya Miyashita1, Hideyuki Takeshima1, Kosuke Makita1, Satoshi Noguchi1, Yasuhiro Yamauchi1 and Takahide Nagase1
1Department of Respiratory Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan, Tokyo, Japan

Acute exacerbation of interstitial pneumonia often cause in inpatients with non-respiratory disease. The diagnosis and treatment are usually difficult and in-hospital mortality is high. However, there are only few studies demonstrating the factors of the disease prognosis.

Aims: To evaluate clinical features and the predictive factors of in-hospital mortality of the exacerbation of interstitial pneumonia in patients hospitalized for non-respiratory diseases.

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Methods: Medical charts of inpatients referred to the Pulmonary Department for the exacerbation of interstitial pneumonia between 2010 and 2016 were retrospectively reviewed.

Results: In total, 33 patients (25 male and 8 female) were analyzed in this study. Average age of the patients was 68.4 (42-86). The types of the interstitial pneumonia were drug-induced pneumonia in 15 patients (45%), acute exacerbation of idiopathic interstitial pneumonia in 9 patients (27%), and acute exacerbation of interstitial lung disease associated with collagen-vascular disease in 4 patients (12%). In-hospital morality rate was 36%. Serum LDH elevations to more than 500 U/L at the onset of exacerbation was significantly associated with in-hospital mortality (p < 0.05); however, age, gender, and other laboratory data including Alb, KL-6, and CRP at the onset of exacerbation did not associate with in-hospital mortality. Further, the value of pulmonary function test such as FVC, FEV1.0 and DLCO/VA did not significantly correlate with in-hospital mortality.

Conclusions: Serum LDH elevations may be a surrogate marker for in-hospital mortality of exacerbation of interstitial pneumonia in patients hospitalized for non-respiratory diseases.

Source :
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PDPI Sulawesi Selatan & Utara. 03/01/18.

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