• Ryo Teramachi, Yasuhiro Kondoh, Kensuke Kataoka, Hiroyuki Taniguchi, Toshiaki Matsuda, Tomoki Kimura, Toshiki Yokoyama, Yasuhiko Yamano, Taiki Furukawa, Koji Sakamoto, Naozumi Hashimoto, and Yoshinori Hasegawa.
• Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Aichi, Japan.
• Respir Med. 2018 Oct 1; 143: 147-152.

BackgroundRespiratory-related hospitalization, in particular acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF), is common and associated with increasing mortality in patients with IPF. We aimed to evaluate the implications of a newly proposed framework of acute respiratory deterioration (ARD) and AE-IPF in hospitalized patients.MethodsUsing the data of an IPF cohort consisting of 225 consecutive patients, we retrospectively studied first hospitalizations from January 2008 to December 2017. We analysed the demographics and 90-day mortality of patients with AE-IPF and those with parenchymal cause of ARD other than AE.ResultsAmong 122 patients with first hospitalization for ARD, 35 patients were diagnosed with AE-IPF, including 11 patients with triggered AE. Parenchymal cause of ARD other than AE was diagnosed in 71 patients, and extra-parenchymal cause in 16 patients. Almost all hospitalized patients (93%) underwent chest CT, and 83% of patients with AE-IPF underwent bronchoalveolar lavage. There was a significant difference in the anti-inflammatory therapy between the AE-IPF group and parenchymal cause of ARD other than AE group (p < 0.001). AE-IPF was independently associated with poor survival in multivariate Cox proportional regression analysis.ConclusionsAE-IPF accounted for about 30% of first hospitalizations for ARD, and differentiation between AE-IPF and the other categories in ARD is important from a therapeutic and a prognostic point of view.Copyright © 2018. Published by Elsevier Ltd.

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