Clinical course and prognosis in survivors of acute exacerbations of idiopathic pulmonary fibrosis

Respir Investig. 2021 Jul;59(4):408-413. doi: 10.1016/j.resinv.2020.12.006. Epub 2021 Feb 3.

Abstract

Background: Patients with idiopathic pulmonary fibrosis (IPF) are at risk of acute exacerbations (AEs) that manifest as respiratory distress. However, the clinical course after AEs of IPF (AE-IPFs) has not been well described. Therefore, we aimed to elucidate the clinical course and prognosis in survivors of AE-IPFs.

Methods: Consecutive patients with IPF who presented to our institution with their first AE-IPFs between January 2008 and December 2019 were included in this study. Data were retrospectively collected, and the clinical course, survival, and cause of death were further analyzed.

Results: Ninety-seven patients were included in this retrospective study. Among them, 67 (69.1%) were discharged alive, with a median survival time after discharge of 1081 days. AE recurrence and pneumonia were the most common causes of death, each accounting for 22.2% of cases among survivors of AE-IPFs. AEs were the most frequent during the first 3 years after discharge, whereas pneumonia was more common thereafter.

Conclusions: Survivors of AE-IPFs have a relatively favorable long-term prognosis. Among the survivors of first AE-IPFs, AE recurrence and pneumonia were the most common causes of death after discharge. Therefore, preventing AE recurrence and lung infections is crucial for prolonging survival in survivors of AE-IPFs.

Keywords: Acute exacerbation; Idiopathic pulmonary fibrosis; Pneumonia; Survivors.

MeSH terms

  • Disease Progression
  • Humans
  • Idiopathic Pulmonary Fibrosis*
  • Prognosis
  • Retrospective Studies
  • Survivors