Takamasa Wada and Hiromi Tomioka*
Department of Respiratory Medicine, Kobe City Medical Center West Hospital, JapanFulltext PDF
Objective: Considering the revised definition and new diagnostic criteria for acute exacerbations of Idiopathic Pulmonary Fibrosis (IPF), which proposed sub categorization of acute exacerbations as “triggered”, it is important to evaluate the significance of pneumonia in managing IPF. This study aimed to describe the clinical features and outcomes of IPF patients hospitalized for pneumonia in the era of the new broader definition of acute exacerbations. Methods: We conducted a retrospective cohort study of consecutive IPF patients admitted to Kobe City Medical Center West Hospital for pneumonia between 2008 and 2017. Baseline demographic and clinical data and outcomes were obtained from clinical records. Severity of pneumonia was evaluated using the A-DROP (Age, Dehydration, Respiratory failure, Orientation disturbance, and low blood Pressure) scoring system. Results: Fifty-six cases (43 males, mean age 79.3±7.5 years) were considered to have pneumonia and 64 cases of acute exacerbation out of 321 cases with IPF were admitted during the study period. Most common pathogen was Streptococcus pneumoniae. Thirty-day and in-hospital mortality were 14.3% and 17.9%, respectively, values that were significantly lower than those for acute exacerbations of IPF (37.5% and 54.7%, respectively). In multiple logistic regression analysis only the A-DROP score was significantly associated with 30-day mortality due to pneumonia (odds ratio 65.0, 95% confidence interval 2.54-1657.47, p<0.0001). Conclusion: Mortality of IPF patients hospitalized for pneumonia was significantly lower than for acute exacerbations of IPF. A-DROP score was significantly associated with 30-day mortality due to pneumonia.
Wada T, Tomioka H. Clinical Features and Outcomes of Idiopathic Pulmonary Fibrosis Patients Hospitalized for Pneumonia. J Respir Med Lung Dis. 2020; 5(1): 1049.